Heikkilä O, Lundbom N, Timonen M, Groop P-H, Heikkinen S, Mäkimattila S
Folkhälsan Research Center, Folkhälsan Institute of Genetics, Biomedicum Helsinki (C330b), University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland.
Diabetologia. 2009 Mar;52(3):534-40. doi: 10.1007/s00125-008-1242-2. Epub 2008 Dec 19.
AIMS/HYPOTHESIS: The aim of the study was to assess the effect of hyperglycaemia on regional concentrations of glucose and other substrates within the brain in non-diabetic individuals and in patients with type 1 diabetes.
The brain metabolites of 17 men with type 1 diabetes and 12 age-matched non-diabetic men (22-43 years old) were studied after an overnight fast (plasma glucose 9.2 +/- 3.0 vs 4.8 +/- 0.5 mmol/l, respectively). N-Acetylaspartate (NAA), creatine, choline, myo-inositol (mI) and glucose in the frontal cortex, frontal white matter and thalamus were quantified with proton magnetic resonance spectroscopy.
In the non-diabetic participants, the glucose level was 47% higher (p < 0.01) in the frontal cortex than in the frontal white matter. In contrast, this regional variation was not observed in the diabetic participants, in whom the glucose level in the frontal white matter was 64% higher (p < 0.001) and in the frontal cortex 25% higher (p = 0.033) than that of the non-diabetic participants. In the diabetic participants, the glucose level in each of the three regions studied correlated with fasting plasma glucose (r = 0.88-0.67, p < 0.01). In addition, in the diabetic participants, mI was 20% higher (p < 0.001) and NAA 6% lower (p = 0.037) in the frontal white matter, and mI was 8% higher (p = 0.042) in the frontal cortex, than in the non-diabetic participants.
CONCLUSIONS/INTERPRETATION: In type 1 diabetes, hyperglycaemia is associated with accumulation of glucose and mI in the cortex and in the white matter.
目的/假设：本研究旨在评估高血糖对非糖尿病个体及1型糖尿病患者脑内局部葡萄糖及其他底物浓度的影响。
对17名1型糖尿病男性患者和12名年龄匹配的非糖尿病男性患者（22 - 43岁）过夜禁食后（血浆葡萄糖分别为9.2±3.0与4.8±0.5 mmol/L）的脑代谢物进行研究。采用质子磁共振波谱法定量检测额叶皮质、额叶白质和丘脑的N - 乙酰天门冬氨酸（NAA）、肌酸、胆碱、肌醇（mI）和葡萄糖。
在非糖尿病参与者中，额叶皮质的葡萄糖水平比额叶白质高47%（p < 0.01）。相比之下，糖尿病参与者未观察到这种局部差异，其中额叶白质的葡萄糖水平比非糖尿病参与者高64%（p < 0.001），额叶皮质高25%（p = 0.033）。在糖尿病参与者中，所研究的三个区域中的每一个区域的葡萄糖水平都与空腹血糖相关（r = 0.88 - 0.67，p < 0.01）。此外，与非糖尿病参与者相比，糖尿病参与者额叶白质中的mI高20%（p < 0.001），NAA低6%（p = 0.037），额叶皮质中的mI高8%（p = 0.042）。
结论/解读：在1型糖尿病中，高血糖与皮质和白质中葡萄糖及mI的积累有关。
