Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands.
J Neurol Sci. 2010 Dec 15;299(1-2):126-30. doi: 10.1016/j.jns.2010.08.048.
Type 2 diabetes mellitus (T2DM) is associated with cortical atrophy on MRI. It is unclear whether this atrophy is global or if there are areas with particular vulnerability. We compared regional cortical atrophy between patients with T2DM and controls and examined determinants of atrophy within the T2DM group.
Cortical surface, volume and thickness were compared between 56 patients with T2DM and 30 controls, both globally and regionally, using the Freesurfer software package. The relationship between atrophy and HbA1c levels, diabetes duration, hypertension, a history of macrovascular disease and cerebral small vessel disease was analyzed within the T2DM group, with linear regression analyses, adjusted for age and gender.
Total cortical surface, total cortical volume and mean cortical thickness for both hemispheres were consistently lower in the T2DM group (between group differences: 0.5-4%), but the effects were only significant in the right hemisphere (p<0.05). Post-hoc regional analyses revealed significant differences in the hippocampal region (between group differences cortical thickness and volume: 5-20.5%) and the middle temporal gyrus (between group differences cortical surface and volume ~8%). Within the T2DM group, smaller cortical thickness of the hippocampal region was associated with cerebral small vessel disease, but no associations between vascular or metabolic determinants and cortical atrophy were found.
The effects of T2DM on cortical grey matter are most pronounced in the temporal lobe. This should be considered when atrophy is used as a marker in etiological or therapeutical studies.
2 型糖尿病（T2DM）与 MRI 上的皮质萎缩有关。目前尚不清楚这种萎缩是全身性的，还是存在特定的脆弱区域。我们比较了 T2DM 患者和对照组之间的区域皮质萎缩，并检查了 T2DM 组内萎缩的决定因素。
使用 Freesurfer 软件包，在全球范围内和局部范围内比较了 56 例 T2DM 患者和 30 例对照组的皮质表面、体积和厚度。在 T2DM 组内，使用线性回归分析，调整年龄和性别，分析了萎缩与 HbA1c 水平、糖尿病病程、高血压、大血管疾病史和脑小血管疾病之间的关系。
T2DM 组的总皮质表面积、总皮质体积和双侧半球的平均皮质厚度均持续较低（组间差异：0.5-4%），但仅在右半球有统计学意义（p<0.05）。事后局部分析显示，在海马区（组间差异皮质厚度和体积：5-20.5%）和颞中回（组间差异皮质表面和体积~8%）存在显著差异。在 T2DM 组内，海马区皮质厚度较小与脑小血管疾病有关，但未发现血管或代谢决定因素与皮质萎缩之间存在关联。
T2DM 对皮质灰质的影响在颞叶最为明显。在病因学或治疗学研究中，当使用萎缩作为标志物时，应考虑这一点。
