Correlation between cortical atrophy and cognitive function in pre-diabetes and type 2 diabetes mellitus
Objective:To explore the change pattern of cerebral cortex in pre-diabetes(PDM)and type 2 diabetes mellitus(T2DM)and its relationship with cognitive function,and explore the early image markers of abnormal blood glucose metabolism.Materials and Methods:This study included 48 normal controls(NC),30 PDM subjects and 96 T2DM patients.Cognitive function test,clinical biochemical examination and high-resolution 3D-T1WI magnetic resonance were performed.The morphological analysis based on voxel and surface was carried out using CAT12 software,and the cortical structural parameters such as the volume of brain gray matter,cortical thickness and sulcus depth were obtained,and the differences among the three groups were compared.The threshold of P<0.05 and FWE correction were used for multiple comparison and correction.Results:Compared to NC,the gray matter volume of right frontal inferior orbital gyrus and left postcentral gyrus of PDM subjects decreased,and the brain gray matter atrophy in T2DM patients,especially the right superior temporal gyrus,right frontal inferior orbital gyrus,the right middle temporal gyrus and the left postcentral gyrus(P<0.05,FWE corrected).Thickness of right prefrontal cortex decreased in T2DM patients(P<0.05,FWE corrected).In the subjects with abnormal blood glucose metabolism,the whole brain gray matter volume is negatively correlated with HOMA-IR(r=-0.227,P=0.012,uncorrected)and Trail Making Test A(r=-0.250,P=0.001,FDR corrected),and positively correlated with the number span-backward(r= 0.267,P=0.003,FDR corrected).Cortical thickness was negatively correlated with hemoglobin A1c(r=-0.181,P=0.040,uncorrected)and postprandial blood glucose at 2 hours(r=-0.272,P=0.020,uncorrected),and positively correlated with postprandial insulin(r=0.236,P=0.010,uncorrected)and HOMA 2-B(r=0.207,P=0.022,uncorrected).Conclusions:In this study,it was found that there was gray matter atrophy in pre-diabetes and global gray matter atrophy in T2DM patients,which was related to attention and working memory function.Therefore,cortical atrophy may be an early imaging marker of diabetes-related brain injury.This suggests that prediabetes subjects should also strictly control blood sugar,and early intervention is beneficial to prevent cognitive impairment and improve prognosis.
type 2 diabetes mellituspre-diabetes mellitusmagnetic resonance imagingcortical atrophycognitive function
国家科技期刊平台
NSTL
万方数据
维普
