Objective To investigate the association between cognitive function and brain structure changes in overweight and obese patients with type 2 diabetes mellitus(T2DM).Methods This was a cross-sectional study.T2DM patients who visited the Endocrinology Department of Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,from February 2016 to July 2023 were collected.T2DM Patients were divided into normal weight T2DM group,overweight and obese T2DM group according to body mass index(BMI).At the same time,we recruited healthy people who visited the Health Management Center of Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,matched for age and education level,and whose 18.5 kg/m2 ≤BMI＜24.0 kg/m2 served as the healthy control group.The age,education level,height and weight of the three groups were collected,and BMI was calculated.The fat mass in android area was measured to calculate the fat mass index(FMI).Immediate memory was assessed using Repeatable Battery for the Assessment of Neuropsychological Status.Left and right hippocampal volumes were measured.Independent-samples t test and one-way analysis of variance were used to compare data between the groups.Covariance one-way analysis of variance was used to compare cognitive function,the volume of total brain and subcortical nuclei.The mediation effect model was used to analyze the mediating effect of brain structure on the relationship between body fat distribution,brain structure and cognitive function.Results A total of 350 people were enrolled,including 50 healthy controls,100 normal weight T2DM patients,200 overweight and obese T2DM patients.Compared with normal weight T2DM group,overweight and obese T2DM patients have higher FMI in android area(t=11.90,P＜0.001).The results of covariance one-way analysis of variance showed that compared with healthy controls and normal weight T2DM patients,overweight and obese T2DM patients have lower immediate memory score(P values were 0.048 and 0.041,respectively)and significantly reduced left and right hippocampal volume(P values were 0.002 and 0.036 on the left side and P values were 0.004 and 0.022 on the right side,respectively).Mediation effect model analysis showed that in patients with T2DM,the volume of left hippocampus partially mediated the association between FMI of android area and immediate memory score(β=-0.313,95％CI-0.695--0.076).Conclusions Cognitive impairment and hippocampal volume atrophy were more significant in overweight and obese T2DM patients than in normal weight T2DM patients.Increased abdominal fat in T2DM patients is associated with cognitive impairment and hippocampal volume atrophy.
关键词
糖尿病,2型/磁共振成像/超重及肥胖/认知功能/人体成分分析
Key words
Diabetes mellitus,type 2/Magnetic resonance imaging/Overweight and obesity/Cognitive function/Body composition
维普
万方数据