Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands.
Diabetes Care. 2010 Jun;33(6):1309-14. doi: 10.2337/dc09-1923. Epub 2010 Mar 18.
Type 2 diabetes is associated with a moderate degree of cerebral atrophy and a higher white matter hyperintensity (WMH) volume. How these brain-imaging abnormalities evolve over time is unknown. The present study aims to quantify cerebral atrophy and WMH progression over 4 years in type 2 diabetes.
A total of 55 patients with type 2 diabetes and 28 age-, sex-, and IQ-matched control participants had two 1.5T magnetic resonance imaging scans with a 4-year interval. Volumetric measurements of total brain, peripheral cerebrospinal fluid (CSF), lateral ventricles, and WMH were performed with k-nearest neighbor-based probabilistic segmentation. All volumes were expressed as percentage of intracranial volume. Linear regression analyses, adjusted for age and sex, were performed to compare brain volumes between the groups and to identify determinants of volumetric change within the type 2 diabetic group.
At baseline, patients with type 2 diabetes had a significantly smaller total brain volume and larger peripheral CSF volume than control participants. In both groups, all volumes showed a significant change over time. Patients with type 2 diabetes had a greater increase in lateral ventricular volume than control participants (mean adjusted between-group difference in change over time [95% CI]: 0.11% in 4 years [0.00 to 0.22], P = 0.047).
The greater increase in lateral ventricular volume over time in patients with type 2 diabetes compared with control participants shows that type 2 diabetes is associated with a slow increase of cerebral atrophy over the course of years.
2 型糖尿病与中度脑萎缩和更高的脑白质高信号（WMH）体积有关。这些脑成像异常如何随时间演变尚不清楚。本研究旨在定量研究 2 型糖尿病患者在 4 年内脑萎缩和 WMH 的进展情况。
共有 55 例 2 型糖尿病患者和 28 名年龄、性别和智商匹配的对照组参与者，在 4 年的间隔时间内进行了两次 1.5T 磁共振成像扫描。使用基于 K-最近邻的概率分割法对总脑、外周脑脊髓液（CSF）、侧脑室和 WMH 的体积进行测量。所有体积均表示为颅内体积的百分比。进行线性回归分析，调整年龄和性别，比较两组之间的脑体积，并确定 2 型糖尿病组内体积变化的决定因素。
在基线时，2 型糖尿病患者的总脑体积明显小于对照组，外周 CSF 体积明显大于对照组。在两组中，所有体积均随时间发生显著变化。2 型糖尿病患者的侧脑室体积增加幅度明显大于对照组（平均调整组间差异随时间变化[95%CI]：4 年内增加 0.11%[0.00 至 0.22]，P=0.047）。
与对照组相比，2 型糖尿病患者的侧脑室体积随时间的增加更大，表明 2 型糖尿病与多年来脑萎缩的缓慢增加有关。
