Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA, USA.
Diabetes Care. 2012 Nov;35(11):2167-73. doi: 10.2337/dc12-0017. Epub 2012 Sep 10.
To detect clinical correlates of cognitive abilities and white matter (WM) microstructural changes using diffusion tensor imaging (DTI) in young children with type 1 diabetes.
Children, ages 3 to <10 years, with type 1 diabetes (n = 22) and age- and sex-matched healthy control subjects (n = 14) completed neurocognitive testing and DTI scans.
Compared with healthy controls, children with type 1 diabetes had lower axial diffusivity (AD) values (P = 0.046) in the temporal and parietal lobe regions. There were no significant differences between groups in fractional anisotropy and radial diffusivity (RD). Within the diabetes group, there was a significant, positive correlation between time-weighted HbA(1c) and RD (P = 0.028). A higher, time-weighted HbA(1c) value was significantly correlated with lower overall intellectual functioning measured by the full-scale intelligence quotient (P = 0.03).
Children with type 1 diabetes had significantly different WM structure (as measured by AD) when compared with controls. In addition, WM structural differences (as measured by RD) were significantly correlated with their HbA(1c) values. Additional studies are needed to determine if WM microstructural differences in young children with type 1 diabetes predict future neurocognitive outcome.
使用弥散张量成像（DTI）检测 1 型糖尿病儿童认知能力和白质（WM）微观结构变化的临床相关性。
年龄在 3 至<10 岁之间的 1 型糖尿病儿童（n=22）和年龄、性别匹配的健康对照者（n=14）完成神经认知测试和 DTI 扫描。
与健康对照组相比，1 型糖尿病儿童的颞叶和顶叶区域轴向弥散系数（AD）值较低（P=0.046）。两组间各向异性分数和径向弥散系数（RD）无显著差异。在糖尿病组中，时间加权 HbA1c 与 RD 之间存在显著的正相关关系（P=0.028）。较高的时间加权 HbA1c 值与全智商测量的整体智力功能明显降低呈显著相关（P=0.03）。
与对照组相比，1 型糖尿病儿童的 WM 结构（以 AD 衡量）存在明显差异。此外，WM 结构差异（以 RD 衡量）与他们的 HbA1c 值显著相关。需要进一步研究以确定 1 型糖尿病儿童的 WM 微观结构差异是否能预测未来的神经认知结局。
