Zhang Guanye, Wu Huanhua, Cao Qian, Mo Jiabin, Cao Xiaozheng, Luo Hong, Tan Xiangyu, Ou Hongru
Department of Radiology, The Affiliated Shunde Hospital of Jinan University, Foshan, Guangdong Province, 528305, PR China.
Central Laboratory, The Affiliated Shunde Hospital of Jinan University, No. 50 East, Guizhou Avenue, Foshan, Guangdong Province, 528305, PR China.
BMC Med Imaging. 2025 May 5;25(1):153. doi: 10.1186/s12880-025-01696-z.
Type 2 diabetes mellitus (T2DM) has been associated with brain microstructural alterations, potentially contributing to cognitive decline and neurodegeneration. Diffusion tensor imaging (DTI) provides a non-invasive method to assess these changes. However, the relationship between glycemic control and brain microstructural integrity remains unclear. This study aims to investigate the association between glycemic control and brain microstructural changes in T2DM using DTI.
This retrospective study included 90 participants (30 healthy controls, 60 T2DM patients) who underwent 1.5T MRI DTI at The Affiliated Shunde Hospital of Jinan University between January 2023 and May 2024. T2DM patients were categorized into well-controlled (HbA1c < 7%, n = 30) and poorly controlled (HbA1c ≥ 7%, n = 30) groups. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were analyzed across multiple white matter regions. Pearson's correlation was used to assess associations between HbA1c and DTI metrics, while group differences were evaluated using Bayesian effect size estimation.
HbA1c negatively correlated with ADC values in the right hippocampus (r = -0.33, p = 0.0013), suggesting a relationship between poor glycemic control and increased tissue diffusivity. A weak but significant positive correlation between HbA1c and FA in the right hippocampus (r = 0.23, p = 0.03) was observed. ADC values were higher in the poorly controlled T2DM group, indicating potential diabetes-related microstructural changes. No significant FA or ADC differences were found in other brain regions (p > 0.05).
Poor glycemic control in T2DM is associated with microstructural alterations in the right hippocampus, potentially reflecting early neurodegenerative processes. Longitudinal studies are needed to further investigate these findings.
2型糖尿病（T2DM）与脑微结构改变有关，这可能导致认知能力下降和神经退行性变。扩散张量成像（DTI）提供了一种评估这些变化的非侵入性方法。然而，血糖控制与脑微结构完整性之间的关系仍不清楚。本研究旨在使用DTI研究T2DM患者血糖控制与脑微结构变化之间的关联。
这项回顾性研究纳入了90名参与者（30名健康对照者，60名T2DM患者），他们于2023年1月至2024年5月在暨南大学附属顺德医院接受了1.5T磁共振成像DTI检查。T2DM患者被分为血糖控制良好组（糖化血红蛋白<7%，n = 30）和血糖控制不佳组（糖化血红蛋白≥7%，n = 30）。分析了多个白质区域的分数各向异性（FA）和表观扩散系数（ADC）值。采用Pearson相关性分析评估糖化血红蛋白与DTI指标之间的关联，同时使用贝叶斯效应大小估计评估组间差异。
糖化血红蛋白与右侧海马体的ADC值呈负相关（r = -0.33，p = 0.0013），表明血糖控制不佳与组织扩散率增加之间存在关联。在右侧海马体中观察到糖化血红蛋白与FA之间存在微弱但显著的正相关（r = 0.23，p = 0.03）。血糖控制不佳的T2DM组的ADC值较高，表明存在潜在的糖尿病相关微结构变化。在其他脑区未发现显著的FA或ADC差异（p > 0.05）。
T2DM患者血糖控制不佳与右侧海马体的微结构改变有关，这可能反映了早期神经退行性变过程。需要进行纵向研究以进一步探究这些发现。
