Gao Mingxuan, Gong Liya, Zeng Yanmei, Li Dongling, Wen Junyan, Guo Ying, Li Zhujia, Luo Jingwen, Chen Chunling, Wen Ge
Nanfang Hospital, Southern Medical University, Guangzhou, China.
Front Neuroimaging. 2025 Jul 15;4:1615654. doi: 10.3389/fnimg.2025.1615654. eCollection 2025.
To investigate the alterations of brain structure and function in brain regions related to ingestive desire in overweight/obese T2DM patients, and the correlation with clinical data.
52 patients with overweight/obese type 2 diabetes mellitus (T2DM group), 62 patients with simple obesity (OB group), and 40 healthy subjects (HC group).
By means of gray matter morphometric indices (cortical thickness, surface area, etc.), resting-state functional magnetic resonance indices (ALFF, ReHo, FC) and DTI eigenvalues (AD, MD, etc.).
Comparisons among the three groups were made using one-way ANOVA, bonferroni test for two-way comparisons, and spearman for correlation analysis.
Compared with the OB and HC groups, the T2DM group showed a significant reduction in cortical thickness in the bilateral superior frontal gyrus, inferior frontal gyrus orbital region, and the lower part of the right middle frontal gyrus, and the functional connectivity of the prefrontal cortex showed a significant trend of enhancement. Meanwhile, compared with the HC group, the T2DM group showed a significant decrease in FA (fractional anisotropy) values in the midline region of the orbitofrontal cortex bilaterally, and the left inferior frontal gyrus orbital region also showed a significant decrease in FA values, whereas AD (axial diffusivity), MD (mean diffusivity), and RD (radial diffusivity) increased significantly.
T2DM patients have significant alterations in gray matter structure, brain white matter integrity and brain function, and most of the brain regions with significant differences are in the prefrontal cortex, which confirms that the abnormal desire to ingest in T2DM patients is closely related to the functional alterations of the reward system, and that observing the brain function and structural changes of the reward loop through imaging may help in the early diagnosis and treatment of overweight/obese T2DM patients.
探讨超重/肥胖2型糖尿病（T2DM）患者与摄食欲望相关脑区的脑结构和功能改变及其与临床数据的相关性。
52例超重/肥胖2型糖尿病患者（T2DM组）、62例单纯肥胖患者（OB组）和40例健康受试者（HC组）。
采用灰质形态学指标（皮质厚度、表面积等）、静息态功能磁共振指标（ALFF、ReHo、FC）和DTI特征值（AD、MD等）。
三组间比较采用单因素方差分析，两组比较采用Bonferroni检验，相关性分析采用Spearman检验。
与OB组和HC组相比，T2DM组双侧额上回、额下回眶部及右侧额中回下部皮质厚度显著降低，前额叶皮质功能连接呈显著增强趋势。同时，与HC组相比，T2DM组双侧眶额皮质中线区域FA（分数各向异性）值显著降低，左侧额下回眶部区域FA值也显著降低，而AD（轴向扩散率）、MD（平均扩散率）和RD（径向扩散率）显著升高。
T2DM患者在灰质结构、脑白质完整性和脑功能方面存在显著改变，且大部分有显著差异的脑区位于前额叶皮质，这证实T2DM患者异常的摄食欲望与奖赏系统功能改变密切相关，通过影像学观察奖赏环路的脑功能和结构变化可能有助于超重/肥胖T2DM患者的早期诊断和治疗。
