Liu Jia, Liu Taiyuan, Wang Wenhui, Ma Lun, Ma Xiaoyue, Shi Shaojie, Gong Qiyong, Wang Meiyun
Department of Radiology, Henan Provincial People's Hospital and the People's Hospital of Zhengzhou UniversityZhengzhou, China.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China.
Front Aging Neurosci. 2017 May 22;9:161. doi: 10.3389/fnagi.2017.00161. eCollection 2017.
Previous studies of voxel-based morphometry (VBM) have found that patients with type 2 diabetes mellitus (T2DM) exhibit gray matter alterations, but these findings are inconsistent and have not been quantitatively reviewed. Therefore, the aim of this study was to conduct a quantitative meta-analysis of VBM studies of patients with T2DM. The seed-based d mapping method was applied to quantitatively estimate the regional gray matter abnormalities in T2DM patients. We also used meta-regression to explore the effects of some demographics and clinical characteristics. Seven studies, with 8 datasets comprising 530 participants with T2DM and 549 non-T2DM controls, were included. The pooled and subgroup meta-analyses found that T2DM patients showed robustly reduced gray matter in the bilateral superior temporal gyrus, middle temporal gyrus, medial superior frontal gyrus, insula, median cingulate cortex, precuneus cortex and the left lentiform nucleus extending into the parahippocampus. The meta-regression also found that the percentage of female patients with T2DM was negatively associated with gray matter in the right superior temporal gyrus and illness duration was negatively associated with gray matter in the right middle temporal gyrus. This meta-analysis indicates that T2DM patients have significantly and robustly reduced gray matter mainly in the cortical-striatal-limbic networks, which are associated with human cognition. Thereby implicating this finding in the pathophysiology of cognitive impairment in T2DM patients.
以往基于体素的形态学测量（VBM）研究发现，2型糖尿病（T2DM）患者存在灰质改变，但这些发现并不一致，且尚未进行定量综述。因此，本研究旨在对T2DM患者的VBM研究进行定量荟萃分析。采用基于种子点的d映射方法定量评估T2DM患者的局部灰质异常。我们还使用荟萃回归来探讨一些人口统计学和临床特征的影响。纳入了7项研究，共8个数据集，包括530例T2DM患者和549例非T2DM对照。汇总和亚组荟萃分析发现，T2DM患者双侧颞上回、颞中回、额上内侧回、岛叶、扣带回中部、楔前叶皮质以及延伸至海马旁回的左侧豆状核灰质明显减少。荟萃回归还发现，T2DM女性患者的比例与右侧颞上回灰质呈负相关，病程与右侧颞中回灰质呈负相关。这项荟萃分析表明，T2DM患者主要在与人类认知相关的皮质-纹状体-边缘网络中存在显著且明显的灰质减少。从而将这一发现与T2DM患者认知障碍的病理生理学联系起来。
