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Prolactin (PRL), a pituitary hormone involved in glucose regulation and neuroinflammation, may contribute to DACD development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to investigate the relationships and underlying mechanisms between serum PRL and DACD in patients with type 2 diabetes (T2DM) via neuroimaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five hundred twenty-two with normal cognition and 418 with mild cognitive impairment (MCI) were included after age- and gender-matching among 1167 participants with T2DM. Two hundred forty-seven individuals underwent functional magnetic resonance imaging scans to assess brain structure and function. Structural equation modeling (SEM) was used to explore the mechanism linking serum PRL to cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Relative weight analysis indicated that PRL and luteinizing hormone (LH) accounted for 8.14% and 7.53% of MCI risk in T2DM across 1167 participants. However, multivariate logistic regression analysis showed that PRL, rather than LH, was an independent risk factor for MCI in T2DM (odds ratio [OR] = 0.907, 95% confidence intervals [95% CI]: 0.849-0.968, P = .003), with the lowest PRL tertile group showing significant cognitive deficits and reduced hippocampal\u2013amygdaloid volumes. Moreover, SEM indicated that PRL positively influenced cognition and exerted an indirect effect via limbic structures, contributing 14.07% to the total effect. Additionally, the lowest PRL tertile group exhibited a significant decreased functional connectivity between the right amygdala and right frontal lobe, partially mediating the link between serum PRL and MoCA scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Decreased serum PRL is associated with reduced hippocampal and amygdaloid volumes, impaired amygdala functional connectivity, and diminished cognitive performance in T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag067","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:47:13Z","timestamp":1771418833000},"page":"1850-1862","source":"Crossref","is-referenced-by-count":1,"title":["Impact of serum prolactin on cognitive function, brain structure, and function in type 2 diabetes 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