We do not have T2DM as a systematic outcome in our MS subjects, but an intriguing question is whether the association of PCK1 with greater T2LV may represent: (a) microvascular disease of the CNS parenchyma manifesting as white matter hyperintensities; (b) an increased burden of inflammatory disease activity; or (c) both. Here, PCK1 is linked to type 2 diabetes mellitus.