通过沿血管周围间隙的扩散张量成像分析评估2型糖尿病和糖尿病前期病例的组织间液动力学。
Assessing interstitial fluid dynamics in type 2 diabetes mellitus and prediabetes cases through diffusion tensor imaging analysis along the perivascular space.
作者信息
Tuerxun Rukeye, Kamagata Koji, Saito Yuya, Andica Christina, Takabayashi Kaito, Uchida Wataru, Yoshida Seina, Kikuta Junko, Tabata Hiroki, Naito Hitoshi, Someya Yuki, Kaga Hideyoshi, Miyata Mari, Akashi Toshiaki, Wada Akihiko, Taoka Toshiaki, Naganawa Shinji, Tamura Yoshifumi, Watada Hirotaka, Kawamori Ryuzo, Aoki Shigeki
机构信息
Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Faculty of Health Data Science, Juntendo University, Chiba, Japan.
出版信息
Front Aging Neurosci. 2024 Mar 7;16:1362457. doi: 10.3389/fnagi.2024.1362457. eCollection 2024.
BACKGROUND AND PURPOSE
Glymphatic system in type 2 diabetes mellitus (T2DM) but not in the prodrome, prediabetes (Pre-DM) was investigated using diffusion tensor image analysis along the perivascular space (DTI-ALPS). Association between glymphatic system and insulin resistance of prominent characteristic in T2DM and Pre-DM between is yet elucidated. Therefore, this study delves into the interstitial fluid dynamics using the DTI-ALPS in both Pre-DM and T2DM and association with insulin resistance.
MATERIALS AND METHODS
In our cross-sectional study, we assessed 70 elderly individuals from the Bunkyo Health Study, which included 22 with Pre-DM, 18 with T2DM, and 33 healthy controls with normal glucose metabolism (NGM). We utilized the general linear model (GLM) to evaluate the ALPS index based on DTI-ALPS across these groups, considering variables like sex, age, intracranial volume, years of education, anamnesis of hypertension and hyperlipidemia, and the total Fazekas scale. Furthermore, we have explored the relationship between the ALPS index and insulin resistance, as measured by the homeostasis model assessment of insulin resistance (HOMA-IR) using GLM and the same set of covariates.
RESULTS
In the T2DM group, the ALPS index demonstrated a reduction compared with the NGM group [family-wise error (FWE)-corrected < 0.001; Cohen's = -1.32]. Similarly, the Pre-DM group had a lower ALPS index than the NGM group (FWE-corrected < 0.001; Cohen's = -1.04). However, there was no significant disparity between the T2DM and Pre-DM groups (FWE-corrected = 1.00; Cohen's = -0.63). A negative correlation was observed between the ALPS index and HOMA-IR in the combined T2DM and Pre-DM groups (partial correlation coefficient = -0.35, < 0.005).
CONCLUSION
The ALPS index significantly decreased in both the pre-DM and T2DM groups and showed a correlated with insulin resistance. This indicated that changes in interstitial fluid dynamics are associated with insulin resistance.
背景与目的
采用沿血管周围间隙的扩散张量成像分析（DTI-ALPS）研究2型糖尿病（T2DM）而非前驱糖尿病（糖尿病前期，Pre-DM）中的类淋巴系统。类淋巴系统与T2DM和Pre-DM中显著特征的胰岛素抵抗之间的关联尚未阐明。因此，本研究使用DTI-ALPS深入探究Pre-DM和T2DM中的组织液动力学及其与胰岛素抵抗的关联。
材料与方法
在我们的横断面研究中，我们评估了来自文京区健康研究的70名老年人，其中包括22名Pre-DM患者、18名T2DM患者和33名葡萄糖代谢正常（NGM）的健康对照者。我们使用一般线性模型（GLM）基于DTI-ALPS评估这些组的ALPS指数，同时考虑性别、年龄、颅内体积、受教育年限、高血压和高脂血症病史以及 Fazekas 量表总分等变量。此外，我们使用GLM和同一组协变量探讨了ALPS指数与胰岛素抵抗之间的关系，胰岛素抵抗通过胰岛素抵抗稳态模型评估（HOMA-IR）来衡量。
结果
在T2DM组中，与NGM组相比，ALPS指数降低[家族性错误率（FWE）校正 < 0.001；Cohen's d = -1.32]。同样，Pre-DM组的ALPS指数低于NGM组（FWE校正 < 0.001；Cohen's d = -1.04）。然而，T2DM组和Pre-DM组之间没有显著差异（FWE校正 = 1.00；Cohen's d = -0.63）。在合并的T2DM和Pre-DM组中，观察到ALPS指数与HOMA-IR之间存在负相关（偏相关系数 = -0.35，P < 0.005）。
结论
Pre-DM组和T2DM组的ALPS指数均显著降低，且与胰岛素抵抗相关。这表明组织液动力学变化与胰岛素抵抗有关。
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