1 型糖尿病的神经病变表型与磁共振光谱评估的脑代谢物的不同特征有关。

Neuropathic phenotypes of type 1 diabetes are related to different signatures of magnetic resonance spectroscopy-assessed brain metabolites.

机构信息

Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark; Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark; Steno Diabetes Center North Denmark, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, Denmark.

出版信息

Clin Neurophysiol. 2024 Oct;166:11-19. doi: 10.1016/j.clinph.2024.06.017. Epub 2024 Jul 16.

DOI:10.1016/j.clinph.2024.06.017

PMID:39084155

Abstract

OBJECTIVES

The study aimed to investigate brain metabolites in type 1 diabetes and the associations with disease characteristics. We explored the metabolic profiles predicting different neuropathic phenotypes using multiple linear regression analyses.

METHODS

We compared brain metabolites in 55 adults with type 1 diabetes (including painful diabetic peripheral neuropathy (DPN), painless DPN, without DPN) with 20 healthy controls. Proton magnetic resonance spectroscopy measurements (N-acetylaspartate (NAA), glutamate (glu), myo-inositol (mI), and glycerophosphocholine (GPC) were obtained in ratios to creatine (cre)) from the parietal region, anterior cingulate cortex and thalamus.

RESULTS

The overall diabetes group revealed decreased parietal NAA/cre compared to healthy controls (1.41 ± 0.12 vs. 1.55 ± 0.13,p < 0.001) and increased mI/cre (parietal: 0.62 ± 0.08 vs. 0.57 ± 0.07,p = 0.025, cingulate: 0.65 ± 0.08 vs. 0.60 ± 0.08,p = 0.033). Reduced NAA/cre was associated with more severe DPN (all p ≤ 0.04) whereas increased mI/cre was associated with higher hemoglobin A (HbA) (p = 0.02). Diabetes was predicted from decreased parietal NAA/cre, increased parietal ml/cre, and decreased thalamic glu/cre. DPN was predicted from decreased parietal NAA/cre and increased GPC/cre. Painful DPN was predicted from increased parietal GPC/cre and thalamic glu/cre.

CONCLUSIONS

Specific metabolic brain profiles were linked to the different phenotypes of diabetes, DPN and painful DPN.

SIGNIFICANCE

Assessment of metabolic profiles could be relevant for detailed understanding of central neuropathy in diabetes.

摘要

目的

本研究旨在探讨 1 型糖尿病患者的脑代谢物及其与疾病特征的关系。我们通过多元线性回归分析探讨了预测不同神经病变表型的代谢谱。

方法

我们比较了 55 例 1 型糖尿病患者（包括痛性糖尿病周围神经病变（DPN）、无痛性 DPN、无 DPN）和 20 例健康对照者的脑代谢物。采用质子磁共振波谱测量（N-乙酰天冬氨酸（NAA）、谷氨酸（glu）、肌醇（mI）和甘油磷酰胆碱（GPC）与肌酸（cre）的比值），来自顶叶、前扣带回皮质和丘脑。

结果

与健康对照组相比，整体糖尿病组顶叶 NAA/cre 降低（1.41±0.12 与 1.55±0.13，p<0.001），mI/cre 增加（顶叶：0.62±0.08 与 0.57±0.07，p=0.025，扣带回：0.65±0.08 与 0.60±0.08，p=0.033）。NAA/cre 降低与更严重的 DPN 相关（均 p≤0.04），而 mI/cre 增加与较高的血红蛋白 A（HbA）相关（p=0.02）。糖尿病由顶叶 NAA/cre 降低、顶叶 mI/cre 增加和丘脑 glu/cre 降低预测。DPN 由顶叶 NAA/cre 降低和 GPC/cre 增加预测。痛性 DPN 由顶叶 GPC/cre 和丘脑 glu/cre 增加预测。