Correlation analysis of MRI subcortical structure volume and cognitive dysfunction of type 2 diabetes mellitus patients
Objective To explore the correlation between cognitive impairment and the volume of subcortical structures in patients with type 2 diabetes mellitus(T2DM).Methods A total of 110 T2DM patients treated in our hospital from June,2020 to June,2023 were selected as the research objects.According to whether cognitive function was abnormal,they were divided into normal group(n=57)and abnormal group(n=53).The clinical data,mini-mental state examination(MMSE)score and Montreal cognitive assessment(MoCA)score,blood glucose fluctuation level,and MRI subcortical structure volume were compared between the two groups.Logistic regression model was used to analyze the independent influencing factors of cognitive impairment in T2DM patients.Multiple linear regression analysis was used to analyze the relationship between blood glucose fluctuation level and the volume of subcortical structures on MRI.Pearson partial correlation was used to analyze the correlation between the volume of subcortical structures on MRI and cognitive function.Results Compared with the normal group,the abnormal group had significant decreases in MMSE score and MoCA score(P＜0.05).Compared with the normal group,the abnormal group had significant increases in mean amplitude glycemic excursion MAGE,standard deviation of blood glucose(SDBG),absolute mean of daily difference(MOOD)and coefficient of variation(CV)(P＜0.05);the volumes of left hippocampus,right hippocampus,left thalamus,right thalamus,left amygdala,right amygdala,left nucleus accumbens,right nucleus accumbens,left globus pallidus,right globus pallidus,brain stem and total subcortical gray matter were significantly decreased(P＜0.05).Further Logistic regression analysis showed that MAGE,SDBG,CV,left hippocampus,right hippocampus,left thalamus,right thalamus,left amygdala and right amygdala were independently associated with cognitive dysfunction in T2DM patients(P＜0.05).The results of multiple linear regression analysis showed that MAGE,SDBG and CV were independent risk factors for the volume reduction of left hippocampus,right hippocampus,left thalamus,right thalamus,left amygdala and right amygdala(β＜0,P＜0.05).Pearson partial correlation analysis showed that hippocampus,thalamus and amygdala were significantly correlated with MMSE score and MoCA score(P＜0.05).Conclusion The increased amplitude of blood glucose fluctuation in T2DM patients leads to the decrease of the volume of subcortical structures such as hippocampus,thalamus and amygdala,which leads to the abnormal cognitive function.
Type 2 diabetes mellitusCognitive dysfunctionMagnetic resonance imagingSubcortical structure volumeCorrelation
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