Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Diabetes Care. 2013 Jan;36(1):90-7. doi: 10.2337/dc12-0555. Epub 2012 Aug 29.
To study how type 2 diabetes adversely affects brain volumes, changes in volume, and cognitive function.
Regional brain volumes and ischemic lesion volumes in 1,366 women, aged 72-89 years, were measured with structural brain magnetic resonance imaging (MRI). Repeat scans were collected an average of 4.7 years later in 698 women. Cross-sectional differences and changes with time between women with and without diabetes were compared. Relationships that cognitive function test scores had with these measures and diabetes were examined.
The 145 women with diabetes (10.6%) at the first MRI had smaller total brain volumes (0.6% less; P = 0.05) and smaller gray matter volumes (1.5% less; P = 0.01) but not white matter volumes, both overall and within major lobes. They also had larger ischemic lesion volumes (21.8% greater; P = 0.02), both overall and in gray matter (27.5% greater; P = 0.06), in white matter (18.8% greater; P = 0.02), and across major lobes. Overall, women with diabetes had slightly (nonsignificant) greater loss of total brain volumes (3.02 cc; P = 0.11) and significant increases in total ischemic lesion volumes (9.7% more; P = 0.05) with time relative to those without diabetes. Diabetes was associated with lower scores in global cognitive function and its subdomains. These relative deficits were only partially accounted for by brain volumes and risk factors for cognitive deficits.
Diabetes is associated with smaller brain volumes in gray but not white matter and increasing ischemic lesion volumes throughout the brain. These markers are associated with but do not fully account for diabetes-related deficits in cognitive function.
研究 2 型糖尿病如何对脑容量、体积变化和认知功能产生不利影响。
对 1366 名年龄在 72-89 岁的女性进行了结构性脑磁共振成像（MRI）测量，以获得区域性脑容量和缺血性病变体积。其中 698 名女性在平均 4.7 年后进行了重复扫描。比较了有无糖尿病的女性之间的横断面差异和随时间的变化。还检查了认知功能测试评分与这些指标和糖尿病之间的关系。
在第一次 MRI 检查中，有 145 名女性患有糖尿病（10.6%），她们的总脑容量较小（少 0.6%；P=0.05），灰质体积较小（少 1.5%；P=0.01），但白质体积没有差异，无论是整体还是主要脑叶。她们的缺血性病变体积也较大（多 21.8%；P=0.02），无论是整体还是灰质（多 27.5%；P=0.06），白质（多 18.8%；P=0.02），还是主要脑叶。总的来说，与无糖尿病的女性相比，患有糖尿病的女性总脑容量的损失略大（3.02cc；P=0.11），总缺血性病变体积的增加更明显（多 9.7%；P=0.05）。糖尿病与全球认知功能及其子领域的评分较低相关。这些相对缺陷仅部分由脑容量和认知缺陷的危险因素解释。
糖尿病与灰质而不是白质的脑容量较小以及整个大脑的缺血性病变体积增加有关。这些标志物与但不能完全解释糖尿病与认知功能缺陷相关的标志物。
