Recent advance in role of cerebral microvascular lesions in type 2 diabetes mellitus-associated cognitive impairment
刘利民 1陈佳园 1熊静 1凌桂芳
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作者信息
1. 昆明医科大学第二附属医院神经内科，昆明 650031
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摘要
认知障碍是2型糖尿病（T2DM）的常见合并症。T2DM对认知功能的影响是多因素、多环节的综合作用。脑微血管病变是T2DM和T2DM前期患者的重要病理改变，可引起血脑屏障损伤、脑血管调节功能受损、神经血管解耦联和脑血流量减少，参与认知损害的发生和发展。本文综述了T2DM脑微血管病变与认知障碍相关的流行病学、病理生理机制研究进展，及如何对脑微血管结构和功能变化进行监测，以期为T2DM认知障碍的诊断和治疗提供新途径。 Cognitive impairment is a common clinical complication in type 2 diabetes (T2DM). T2DM-related cognitive impairment has complex and multifactorial pathogenesis. Cerebral microvascular dysfunction is an important pathological change in patients with T2DM and pre-T2DM, and it can induce blood-brain barrier injury and impaired blood perfusion regulation, with disturbed neurovascular coupling and cerebral autoregulation, leading cognitive impairment. This article reviews the epidemiology and pathophysiological mechanisms related to T2DM cerebral microvascular lesions and cognitive impairment, and how to monitor changes of cerebral microvascular structure and function so as to provide new approach for diagnosis and treatment of T2DM-related cognitive impairment.
Abstract
Cognitive impairment is a common clinical complication in type 2 diabetes (T2DM). T2DM-related cognitive impairment has complex and multifactorial pathogenesis. Cerebral microvascular dysfunction is an important pathological change in patients with T2DM and pre-T2DM, and it can induce blood-brain barrier injury and impaired blood perfusion regulation, with disturbed neurovascular coupling and cerebral autoregulation, leading cognitive impairment. This article reviews the epidemiology and pathophysiological mechanisms related to T2DM cerebral microvascular lesions and cognitive impairment, and how to monitor changes of cerebral microvascular structure and function so as to provide new approach for diagnosis and treatment of T2DM-related cognitive impairment.
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