Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ito Clinic, Kyushu University, Fukuoka, Japan.
Diabetes Care. 2022 Jun 2;45(6):1364-1371. doi: 10.2337/dc21-1911.
To examine the association between diabetes and gray matter atrophy patterns in a general older Japanese population.
In 2012, a total of 1,189 community-dwelling Japanese aged ≥65 years underwent brain MRI scans. Regional gray matter volumes (GMV) and intracranial volume (ICV) were measured by applying voxel-based morphometry (VBM) methods. The associations of diabetes and related parameters with the regional GMV/ICV were examined using an ANCOVA. The regional gray matter atrophy patterns in the subjects with diabetes or elevated fasting plasma glucose (FPG) or 2-h postload glucose (2hPG) levels were investigated using VBM.
Subjects with diabetes had significantly lower mean values of GMV/ICV in the frontal lobe, temporal lobe, insula, deep gray matter structures, and cerebellum than subjects without diabetes after adjusting for potential confounders. A longer duration of diabetes was also significantly associated with lower mean values of GMV/ICV in these brain regions. The multivariable-adjusted mean values of the temporal, insular, and deep GMV/ICV decreased significantly with elevating 2hPG levels, whereas higher FPG levels were not significantly associated with GMV/ICV of any brain regions. In the VBM analysis, diabetes was associated with gray matter atrophy in the bilateral superior temporal gyri, right middle temporal gyrus, left inferior temporal gyrus, right middle frontal gyrus, bilateral thalami, right caudate, and right cerebellum.
The current study suggests that a longer duration of diabetes and elevated 2hPG levels are significant risk factors for gray matter atrophy in various brain regions.
在日本一般老年人群体中，研究糖尿病与灰质萎缩模式之间的关系。
2012 年，共有 1189 名居住在社区的年龄≥65 岁的日本老年人接受了脑部 MRI 扫描。通过体素形态计量学（VBM）方法测量了区域灰质体积（GMV）和颅内体积（ICV）。采用协方差分析（ANCOVA）检验糖尿病及其相关参数与区域 GMV/ICV 的相关性。使用 VBM 研究了患有糖尿病或空腹血糖（FPG）或 2 小时餐后血糖（2hPG）水平升高的受试者的区域性灰质萎缩模式。
在调整了潜在混杂因素后，患有糖尿病的受试者的额叶、颞叶、脑岛、深部灰质结构和小脑的 GMV/ICV 平均值明显低于无糖尿病的受试者。糖尿病的病程较长也与这些脑区 GMV/ICV 的平均值较低显著相关。多变量调整后的颞叶、脑岛和深部 GMV/ICV 平均值随着 2hPG 水平的升高而显著降低，而较高的 FPG 水平与任何脑区的 GMV/ICV 均无显著相关性。在 VBM 分析中，糖尿病与双侧颞上回、右侧颞中回、左侧颞下回、右侧额中回、双侧丘脑、右侧尾状核和右侧小脑的灰质萎缩有关。
本研究表明，糖尿病病程较长和 2hPG 水平升高是各脑区灰质萎缩的重要危险因素。
