Li Yu-Lin, Wu Jia-Jia, Ma Jie, Li Si-Si, Xue Xin, Wei Dong, Shan Chun-Lei, Hua Xu-Yun, Zheng Mou-Xiong, Xu Jian-Guang
School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Diabetes. 2022 May 1;71(5):894-905. doi: 10.2337/db21-0600.
The aim of this study was to investigate the interactive effect between aging and type 2 diabetes mellitus (T2DM) on brain glucose metabolism, individual metabolic connectivity, and network properties. Using a 2 × 2 factorial design, 83 patients with T2DM (40 elderly and 43 middle-aged) and 69 sex-matched healthy control subjects (HCs) (34 elderly and 35 middle-aged) underwent 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance scanning. Jensen-Shannon divergence was applied to construct individual metabolic connectivity and networks. The topological properties of the networks were quantified using graph theoretical analysis. The general linear model was used to mainly estimate the interaction effect between aging and T2DM on glucose metabolism, metabolic connectivity, and network. There was an interaction effect between aging and T2DM on glucose metabolism, metabolic connectivity, and regional metabolic network properties (all P < 0.05). The post hoc analyses showed that compared with elderly HCs and middle-aged patients with T2DM, elderly patients with T2DM had decreased glucose metabolism, increased metabolic connectivity, and regional metabolic network properties in cognition-related brain regions (all P < 0.05). Age and fasting plasma glucose had negative correlations with glucose metabolism and positive correlations with metabolic connectivity. Elderly patients with T2DM had glucose hypometabolism, strengthened functional integration, and increased efficiency of information communication mainly located in cognition-related brain regions. Metabolic connectivity pattern changes might be compensatory changes for glucose hypometabolism.
本研究的目的是调查衰老与2型糖尿病（T2DM）对脑葡萄糖代谢、个体代谢连通性和网络属性的交互作用。采用2×2析因设计，83例T2DM患者（40例老年患者和43例中年患者）和69例性别匹配的健康对照者（HCs）（34例老年患者和35例中年患者）接受了18F-氟脱氧葡萄糖正电子发射断层扫描/磁共振扫描。应用 Jensen-Shannon 散度构建个体代谢连通性和网络。使用图论分析对网络的拓扑属性进行量化。采用一般线性模型主要估计衰老与T2DM对葡萄糖代谢、代谢连通性和网络的交互作用。衰老与T2DM在葡萄糖代谢、代谢连通性和区域代谢网络属性方面存在交互作用（所有P<0.05）。事后分析表明，与老年HCs和中年T2DM患者相比，老年T2DM患者在认知相关脑区的葡萄糖代谢降低、代谢连通性增加以及区域代谢网络属性改变（所有P<0.05）。年龄和空腹血糖与葡萄糖代谢呈负相关，与代谢连通性呈正相关。老年T2DM患者存在葡萄糖代谢减低、功能整合增强以及主要位于认知相关脑区的信息交流效率增加。代谢连通性模式变化可能是葡萄糖代谢减低的代偿性变化。
