Li Mingrui, Li Yifan, Zhao Kui, Qin Chunhong, Chen Yuna, Liu Yujie, Qiu Shijun, Tan Xin, Liang Yi
First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Endocrine. 2024 Jul;85(1):433-442. doi: 10.1007/s12020-023-03342-6. Epub 2023 Jun 20.
Type 2 diabetes mellitus (T2DM) lead to impaired cerebral blood perfusion, which leads to changes in brain function and affects the cognitive function of patients. In this study, cerebral blood flow (CBF) was used to evaluate the effect of T2DM on cerebral perfusion, and functional connectivity (FC) analysis was further used to explore whether the FC between the abnormal CBF region and the whole brain was changed. In addition, amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were used to investigate the changes in spontaneous activity and connectivity strength of the brain network.
We recruited 40 T2DM patients and 55 healthy controls (HCs). They underwent 3D-T1WI, rs-fMRI, arterial spin labeling (ASL) sequence scans and a series of cognitive tests. Cognitive test scores and brain imaging indicators were compared between the two groups, and the relationships among laboratory indicators, cognitive test scores, and brain imaging indicators were explored in the T2DM group.
Compared to HCs, The CBF values of Calcarine_L and Precuneus_R in the T2DM group were lower. The DC value of Paracentral_Lobule_L and Precuneus_L, and the ALFF value of Hippocampus_L in the T2DM group were higher. In addition, the CBF values of Calcarine_L was negatively correlated with fasting insulin and HOMA_IR.
This study found that there were regions of cerebral hypoperfusion in T2DM patients, which are associated with insulin resistance. In addition, we found abnormally elevated brain activity and enhanced functional connectivity in T2DM patients, which we speculated was the compensatory mechanism of brain neural activity.
2型糖尿病（T2DM）会导致脑血流灌注受损，进而引起脑功能变化并影响患者的认知功能。在本研究中，采用脑血流量（CBF）来评估T2DM对脑灌注的影响，并进一步使用功能连接（FC）分析来探讨CBF异常区域与全脑之间的FC是否发生改变。此外，采用低频振幅（ALFF）和中心度（DC）来研究脑网络自发活动和连接强度的变化。
招募40例T2DM患者和55例健康对照（HC）。他们接受了三维T1加权成像（3D-T1WI）、静息态功能磁共振成像（rs-fMRI）、动脉自旋标记（ASL）序列扫描以及一系列认知测试。比较两组的认知测试分数和脑成像指标，并在T2DM组中探讨实验室指标、认知测试分数和脑成像指标之间的关系。
与HC相比，T2DM组中距状回_L和楔前叶_R的CBF值较低。T2DM组中央旁小叶_L和楔前叶_L的DC值以及海马体_L的ALFF值较高。此外，距状回_L的CBF值与空腹胰岛素和稳态模型评估的胰岛素抵抗（HOMA-IR）呈负相关。
本研究发现T2DM患者存在脑灌注不足区域，这与胰岛素抵抗有关。此外，我们发现T2DM患者脑活动异常升高且功能连接增强，我们推测这是脑神经元活动的代偿机制。
