Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pediatric Neurology, Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei, Taiwan.
Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan; Institute of Biomedical Sciences, Mackay Medical College, New Taipei, Taiwan.
J Formos Med Assoc. 2021 Jan;120(1 Pt 1):157-164. doi: 10.1016/j.jfma.2020.04.011. Epub 2020 Apr 30.
BACKGROUND/PURPOSE: This study aimed to clarify whether brain-derived neurotrophic factor (BDNF) is a biomarker for cognitive dysfunction in children with type 1 diabetes.
We conducted a cross-sectional case-control study of children aged between 6 and 18 years with type 1 diabetes and healthy volunteers. Serum BDNF level was measured in all of the studied children, and they all underwent intelligence tests with the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). We further compared the cognitive function and BDNF levels in the diabetic children with positive glutamic acid decarboxylase 65 antibody (GAD65-Ab) and those with negative GAD65-Ab.
Forty-five children with type 1 diabetes (mean age 14.0 ± 2.6 years, 42% male) and 50 normal controls (mean age 13.2 ± 2.3 years, 54% male) were recruited. The serum BDNF level was significantly lower in the diabetes group than in the controls (15.92 ± 7.2 vs. 18.5 ± 5.1 ng/mL, respectively, t = -2.03, p = 0.045) and much lower in the subgroup with GAD65-Ab positive type 1 diabetes. The average Full-Scale IQ, verbal comprehension, perceptual reasoning and working memory scores in the diabetes group were significantly lower than in the controls (all p < 0.05). Among the children with type 1 diabetes, poor glycemic control was related to lower general cognitive abilities (r = -0.34, p < 0.02), lower verbal comprehension (r = -0.305, p < 0.05), and lower perceptual reasoning scores (r = -0.346, p = 0.02).
The children with type 1 diabetes had a lower serum BDNF level and poorer neurocognitive function than normal healthy children, especially those with GAD65-Ab positive diabetes. Poor glycemic control was correlated with worse cognitive performance.
背景/目的：本研究旨在阐明脑源性神经营养因子（BDNF）是否是 1 型糖尿病患儿认知功能障碍的生物标志物。
我们对 6 至 18 岁的 1 型糖尿病患儿和健康志愿者进行了横断面病例对照研究。对所有研究对象均检测血清 BDNF 水平，并采用韦氏儿童智力量表第四版（WISC-IV）进行智力测试。我们进一步比较了谷氨酸脱羧酶 65 抗体（GAD65-Ab）阳性和阴性的糖尿病患儿的认知功能和 BDNF 水平。
共纳入 45 例 1 型糖尿病患儿（平均年龄 14.0±2.6 岁，42%为男性）和 50 名正常对照（平均年龄 13.2±2.3 岁，54%为男性）。糖尿病组血清 BDNF 水平明显低于对照组（分别为 15.92±7.2 比 18.5±5.1 ng/mL，t=-2.03，p=0.045），且 GAD65-Ab 阳性 1 型糖尿病亚组更低。糖尿病组的全量表智商、言语理解、知觉推理和工作记忆评分均明显低于对照组（均 p<0.05）。在 1 型糖尿病患儿中，血糖控制不佳与整体认知能力降低（r=-0.34，p<0.02）、言语理解能力降低（r=-0.305，p<0.05）和知觉推理评分降低（r=-0.346，p=0.02）相关。
与正常健康儿童相比，1 型糖尿病患儿血清 BDNF 水平较低，神经认知功能较差，尤其是 GAD65-Ab 阳性糖尿病患儿。血糖控制不佳与认知功能下降相关。
