Lobnig B M, Krömeke O, Optenhostert-Porst C, Wolf O T
Department of Endocrinology, Diabetes and Rheumatology, WHO Collaborating Centre, European Training Centre in Endocrinology and Metabolism, University of Duesseldorf, Germany.
Diabet Med. 2006 Jan;23(1):32-9. doi: 10.1111/j.1464-5491.2005.01716.x.
Hippocampal atrophy and memory deficits have been reported in Type 2 diabetes. Whether similar alterations occur in Type 1 diabetes is currently unknown.
In a case-control design, 13 Type 1 diabetic patients with at least 10 years' duration of disease, but free from clinical signs of macrovascular disease, were compared with age- and gender-matched control subjects. Hippocampal volume and measures of global cerebral cerebrospinal fluid (CSF) were determined from magnetic resonance imaging (MRI) scans. Cognitive functions were assessed using four neuropsychological tests. Mood and depression were measured by questionnaires.
Hippocampal volume and memory did not differ between Type 1 diabetic patients and control subjects. However, a significantly increased amount of cerebral CSF suggestive of mild cerebral atrophy was observed in the patients. In addition, deficits in psychomotor speed and selective attention were apparent. Eleven of 13 patients had retinopathy and/or nephropathy. Findings were unrelated to cerebrovascular disease, white matter disease or silent strokes.
Results from our small study in Type 1 diabetic patients do not support findings from previous studies of Type 2 diabetic patients demonstrating reductions in hippocampal volume and impaired memory. On the contrary, we observed evidence for mild cerebral atrophy and impaired psychomotor speed and selective attention. This is in line with some previous studies in Type 1 diabetes. If replicated in larger studies, our findings would support the idea that the effects on brain function and structure differ between Type 1 and Type 2 diabetes.
2型糖尿病患者中已报道有海马萎缩和记忆缺陷。1型糖尿病患者是否会出现类似改变目前尚不清楚。
采用病例对照设计，将13例病程至少10年但无大血管疾病临床体征的1型糖尿病患者与年龄和性别匹配的对照者进行比较。通过磁共振成像（MRI）扫描确定海马体积和全脑脑脊液（CSF）指标。使用四项神经心理学测试评估认知功能。通过问卷调查测量情绪和抑郁情况。
1型糖尿病患者与对照者的海马体积和记忆无差异。然而，观察到患者的脑CSF量显著增加，提示轻度脑萎缩。此外，精神运动速度和选择性注意力存在缺陷。13例患者中有11例患有视网膜病变和/或肾病。研究结果与脑血管疾病、白质疾病或无症状性卒中无关。
我们针对1型糖尿病患者的小型研究结果不支持先前关于2型糖尿病患者海马体积减小和记忆受损的研究结果。相反，我们观察到轻度脑萎缩以及精神运动速度和选择性注意力受损的证据。这与先前一些关于1型糖尿病的研究一致。如果在更大规模的研究中得到重复验证，我们的研究结果将支持1型和2型糖尿病对脑功能和结构的影响不同这一观点。
