Department of Anesthesiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Alzheimers Dement. 2024 Jul;20(7):4583-4593. doi: 10.1002/alz.13882. Epub 2024 Jun 12.
Mild cognitive impairment (MCI) heightens Alzheimer's disease (AD) risk, with diabetes mellitus (DM) potentially exacerbating this vulnerability. This study identifies the optimal intervention period and neurobiological targets in MCI to AD progression using the Alzheimer's Disease Neuroimaging Initiative dataset.
Analysis of 980 MCI patients, categorized by DM status, used propensity score matching and inverse probability treatment weighting to assess rate of conversion from MCI to AD, neuroimaging, and cognitive changes.
DM significantly correlates with cognitive decline and an increased risk of progressing to AD, especially within the first year of MCI follow-up. It adversely affects specific brain structures, notably accelerating nucleus accumbens atrophy, decreasing gray matter volume and sulcal depth.
Findings suggest the first year after MCI diagnosis as the critical window for intervention. DM accelerates MCI-to-AD progression, targeting specific brain areas, underscoring the need for early therapeutic intervention.
Diabetes mellitus (DM) accelerates mild cognitive impairment (MCI)-to-Alzheimer's disease (AD) progression within the first year after MCI diagnosis. DM leads to sharper cognitive decline within 12 months of follow-up. There is notable nucleus accumbens atrophy observed in MCI patients with DM. DM causes significant reductions in gray matter volume and sulcal depth. There are stronger correlations between cognitive decline and brain changes due to DM.
轻度认知障碍（MCI）会增加阿尔茨海默病（AD）的风险，而糖尿病（DM）可能会加剧这种脆弱性。本研究使用阿尔茨海默病神经影像学倡议（Alzheimer's Disease Neuroimaging Initiative）数据集，确定了从 MCI 到 AD 进展的最佳干预期和神经生物学靶点。
对 980 名 MCI 患者进行分析，根据 DM 状态进行分类，使用倾向评分匹配和逆概率处理加权来评估从 MCI 向 AD 转化的速度、神经影像学和认知变化。
DM 与认知下降和向 AD 进展的风险增加显著相关，尤其是在 MCI 随访的第一年。它对特定的大脑结构有不利影响，特别是加速伏隔核萎缩，减少灰质体积和脑沟深度。
研究结果表明，MCI 诊断后的第一年是干预的关键窗口。DM 加速了 MCI 向 AD 的进展，针对特定的大脑区域，这强调了早期治疗干预的必要性。
糖尿病（DM）在 MCI 诊断后第一年加速了轻度认知障碍（MCI）向阿尔茨海默病（AD）的进展。DM 导致随访 12 个月内认知能力急剧下降。患有 DM 的 MCI 患者观察到明显的伏隔核萎缩。DM 导致灰质体积和脑沟深度显著减少。由于 DM，认知能力下降与大脑变化之间的相关性更强。
