Livny Abigail, Ravona-Springer Ramit, Heymann Anthony, Priess Rachel, Kushnir Tammar, Tsarfaty Galia, Rabinov Leeron, Moran Reut, Tik Niv, Moshier Erin, Cooper Itzik, Greenbaum Lior, Silverman Jeremy, Levy Andrew, Sano Mary, Bendlin Barbara B, Buchman Aron S, Schnaider-Beeri Michal
Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel HaShomer, Israel.
Diabetes. 2017 Nov;66(11):2927-2932. doi: 10.2337/db16-0987. Epub 2017 Aug 31.
Recent evidence suggests that glycemic control is associated with cognitive function in older patients with type 2 diabetes who are carriers of the haptoglobin (Hp) 1-1 genotype compared with noncarriers. We assessed whether poor glycemic control in Hp 1-1 carriers is more strongly associated with smaller hippocampal volume than in noncarriers. Hippocampal volume was generated from high-resolution structural T1 MRI obtained for 224 participants (28 Hp 1-1 carriers [12.5%] and 196 noncarriers [87.5%]) from the Israel Diabetes and Cognitive Decline (IDCD) study, who had a mean (SD) number of years in the Maccabi Healthcare Services (MHS) registry of 8.35 (2.63) and a mean (SD) HbA level of 6.66 (0.73)% [49 mmol/mol]. A stronger negative association between right hippocampal volume and HbA was found in patients with the Hp 1-1 genotype, with a 0.032-mL decrease in right hippocampal volume per 14% increase in HbA ( = 0.0007) versus a 0.009-mL decrease in Hp 1-1 noncarriers ( = 0.047), after adjusting for total intracranial volume, age, sex, follow-up years in the registry, and cardiovascular factor (interaction, = 0.025). This indicates that 29.66% of the total variance in right hippocampal volume is explained by HbA levels among Hp 1-1 carriers and that 3.22% is explained by HbA levels among Hp 1-1 noncarriers. Our results suggest that the hippocampus of Hp 1-1 carriers may be more vulnerable to the insults of poor glycemic control.
近期证据表明，与非携带者相比，在携带触珠蛋白（Hp）1-1基因型的老年2型糖尿病患者中，血糖控制与认知功能相关。我们评估了Hp 1-1携带者血糖控制不佳是否比非携带者更易与较小的海马体积相关。海马体积由以色列糖尿病与认知衰退（IDCD）研究中224名参与者（28名Hp 1-1携带者[12.5%]和196名非携带者[87.5%]）的高分辨率结构T1 MRI生成，这些参与者在马卡比医疗服务（MHS）登记处的平均（标准差）年数为8.35（2.63），平均（标准差）糖化血红蛋白（HbA）水平为6.66（0.73）%[49 mmol/mol]。在调整了总颅内体积、年龄、性别、登记处随访年数和心血管因素后，发现Hp 1-1基因型患者右侧海马体积与HbA之间的负相关更强，HbA每增加14%，右侧海马体积减少0.032 mL（P = 0.0007），而Hp 1-1非携带者右侧海马体积减少0.009 mL（P = 0.047）（交互作用，P = 0.025）。这表明，在Hp 1-1携带者中，右侧海马体积总方差的29.66%可由HbA水平解释，在Hp 1-1非携带者中，这一比例为3.22%。我们的结果表明，Hp 1-1携带者的海马可能更容易受到血糖控制不佳的损害。
