Free water–mediated associations among choroid plexus enlargement, white matter lesions, and cognitive performance in type 2 diabetes mellitus

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The study involved 104 T2DM patients and 56 healthy controls, assessing brain MRI and cognitive performance.
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T2DM patients showed larger CP volume, higher FW fraction, and greater PWMH volume compared to controls.
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CP volume and FW fraction were independently associated with PWMH in T2DM patients.
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FW fraction and PWMH were independently linked to cognitive performance as measured by SDMT.
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Mediation analyses indicated significant indirect effects of FW on the relationships between CP, PWMH, and cognitive performance.

Frontiers In Endocrinology

by Ling Li, Peichun Pan, Jing Li, Min Tang, Dongsheng Zhang, Xiaoyan Lei, Xiaoling Zhang, Jie Gao
June 18, 2026

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