Roy Bhaswati, Lubera Veronica, Singh Kamal R, Singh Anshita, Carrier Megan, Choi Sarah E, Freeby Matthew J, Kumar Rajesh
University of California Los Angeles.
University of California at Los Angeles.
Res Sq. 2025 Jul 2:rs.3.rs-6467065. doi: 10.21203/rs.3.rs-6467065/v1.
Type 2 diabetes mellitus (T2DM) is associated with multiple systemic complications, including cognitive decline and increased risk of neurodegenerative diseases. The glymphatic system, a brain waste clearance pathway, can be impaired from sleep disturbances common in T2DM, has not been examined. Therefore, the aim was to evaluate glymphatic system in T2DM subjects using diffusion tensor imaging along the perivascular space (DTI-ALPS) index. A total of 78 T2DM adults and 106 healthy controls underwent for brain MRI. Sleep issues were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and cognition with the Montreal Cognitive Assessment (MoCA). Group differences in DTI-ALPS, sleep metrics, and MoCA scores were assessed with analysis of covariance (covariates, age, sex, and BMI). T2DM patients exhibited higher PSQI (p = 0.03) and ESS (p = 0.004), reflecting poorer sleep quality and increased daytime sleepiness. MoCA scores were significantly lower in T2DM adults (p = 0.001), with impairments emerged in visuospatial skills, attention, and language. Also, significantly reduced DTI-ALPS values appeared in T2DM over controls (p = 0.003). T2DM adults show impaired glymphatic function along with poor sleep quality and day-time issues. The findings indicate that glymphatic dysfunction potentially-driven by metabolic, vascular, and sleep-related disturbances may exacerbate cognitive deficits in T2DM adults.
2型糖尿病（T2DM）与多种全身并发症相关，包括认知能力下降和神经退行性疾病风险增加。糖淋巴系统是一种脑废物清除途径，可能会因T2DM中常见的睡眠障碍而受损，但尚未得到研究。因此，本研究旨在使用沿血管周围间隙的扩散张量成像（DTI-ALPS）指数评估T2DM患者的糖淋巴系统。共有78名T2DM成年人和106名健康对照者接受了脑部MRI检查。使用匹兹堡睡眠质量指数（PSQI）和爱泼华嗜睡量表（ESS）评估睡眠问题，使用蒙特利尔认知评估量表（MoCA）评估认知能力。通过协方差分析（协变量包括年龄、性别和BMI）评估DTI-ALPS、睡眠指标和MoCA评分的组间差异。T2DM患者的PSQI（p = 0.03）和ESS（p = 0.004）较高，反映出睡眠质量较差和白天嗜睡增加。T2DM成年人的MoCA评分显著较低（p = 0.001），在视觉空间技能、注意力和语言方面出现损伤。此外，与对照组相比，T2DM患者的DTI-ALPS值显著降低（p = 0.003）。T2DM成年人表现出糖淋巴功能受损，同时伴有睡眠质量差和白天问题。研究结果表明，由代谢、血管和睡眠相关干扰潜在驱动的糖淋巴功能障碍可能会加剧T2DM成年人的认知缺陷。
