Exploring the Predictive Value of Hippocampal Metabolites for the Development of Mild Cognitive Impairment in Patients with Type Ⅱ Diabetes Based on Quantitative MRS Technique
Objective To explore the predictive value of quantitative magnetic resonance spectroscopy(MRS)for mild cognitive impairment(MCI)in patients with type Ⅱ diabetes mellitus(T2DM).Methods A total of 124 patients diag-nosed with type Ⅱ diabetes were prospectively enrolled,and clinical data,serum indicators,and MRS examinations were collected upon entry.A 2-year longitudinal cognitive function follow-up was conducted.Patients were categorized into the mild cognitive impairment group(MCI)group and the Normal Cognition(NC)group based on the occurrence of cognitive impairment during the follow-up.Differences in baseline clinical data,serum indicators,and MRS indices between the two groups were compared.Independent influencing factors for MCI in T2DM patients were determined using multifactorial logis-tic regression analysis.The predictive efficacy of each factor for the occurrence of MCI was analyzed using Receiver Operat-ing Characteristic(ROC)curves.Results Compared to the NC group,patients in the MCI group exhibited significantly lower baseline HDL-c and hippocampal NAA levels,while BMI and HOMA-IR levels were higher;all differences were statis-tically significant(P＜0.05).Multifactorial logistic regression revealed that HOMA-IR(OR=3.37,95％CI:1.64-6.96,P＜0.01)and hippocampal NAA(OR=0.38,95％CI:0.21-0.68,P＜0.01)were independent influencing fac-tors for the occurrence of MCI in diabetic patients.ROC curve analysis demonstrated AUC values of 0.66 for HOMA-IR,0.64 for NAA levels,and 0.80 for their combined prediction of MCI in T2DM patients.Correlation analysis indicated a neg-ative correlation between MoCA scores at the MCI stage and baseline HOMA-IR(r=-0.552,P＜0.01)and a positive correlation with NAA(r=0.562,P＜0.01).Conclusion Higher levels of insulin resistance and lower levels of hipp-ocampal NAA are closely associated with the occurrence of MCI in patients with type Ⅱ diabetes.
Mild cognitive impairmentDiabetes mellitus type ⅡHippocampusMagnetic resonance spectroscopyInsulin resistance
NETL
NSTL
万方数据
