Effects of hyperglycemia and effects of ketosis on cerebral perfusion, cerebral water distribution, and cerebral metabolism.
Effects of hyperglycemia and effects of ketosis on cerebral perfusion, cerebral water distribution, and cerebral metabolism.
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DOI：
10.2337/db11-1286
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发表时间：
2012-07
期刊：
影响因子：
7.7
通讯作者：
O'Donnell M
中科院分区：
文献类型：
--
作者：
Glaser N;Ngo C;Anderson S;Yuen N;Trifu A;O'Donnell M
糖尿病酮症酸中毒（DKA）可引起儿童脑损伤。由于DKA涉及多种代谢紊乱，其机制难以阐明。我们的目的是确定高血糖和酮症对脑代谢、血流量和水分布的独立影响。我们用磁共振波谱法测量了三组幼年大鼠（高血糖、酮症和正常对照）的脑代谢物（ATP /无机磷酸盐[Pi]、磷酸肌酸[PCr] / Pi、n-乙酰天冬氨酸[NAA] /肌酸[Cr]、乳酸/ Cr）的比值，并用弥散加权成像和灌注加权成像评估了脑水分布（表观扩散系数[ADC]值）和脑血流量（CBF）。与对照组相比，高血糖和酮症大鼠的atp - pi比率均降低。生酮组pcr - pi比值降低，高血糖组有降低趋势。NAA-to-Cr或乳酸-to- cr比值无显著差异。两组皮质ADC均降低（表明脑细胞肿胀）。两组的皮质脑血流也减少。我们的结论是，高血糖和酮症都独立导致大脑高能磷酸盐、CBF和皮质ADC值的降低。这些影响可能在dka相关脑损伤的病理生理学中发挥作用。
Diabetic ketoacidosis (DKA) may cause brain injuries in children. The mechanisms responsible are difficult to elucidate because DKA involves multiple metabolic derangements. We aimed to determine the independent effects of hyperglycemia and ketosis on cerebral metabolism, blood flow, and water distribution. We used magnetic resonance spectroscopy to measure ratios of cerebral metabolites (ATP to inorganic phosphate [Pi], phosphocreatine [PCr] to Pi, N-acetyl aspartate [NAA] to creatine [Cr], and lactate to Cr) and diffusion-weighted imaging and perfusion-weighted imaging to assess cerebral water distribution (apparent diffusion coefficient [ADC] values) and cerebral blood flow (CBF) in three groups of juvenile rats (hyperglycemic, ketotic, and normal control). ATP-to-Pi ratio was reduced in both hyperglycemic and ketotic rats in comparison with controls. PCr-to-Pi ratio was reduced in the ketotic group, and there was a trend toward reduction in the hyperglycemic group. No significant differences were observed in NAA-to-Cr or lactate-to-Cr ratio. Cortical ADC was reduced in both groups (indicating brain cell swelling). Cortical CBF was also reduced in both groups. We conclude that both hyperglycemia and ketosis independently cause reductions in cerebral high-energy phosphates, CBF, and cortical ADC values. These effects may play a role in the pathophysiology of DKA-related brain injury.
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DOI：
10.1111/j.1749-6632.1996.tb34448.x
发表时间：
1996-01-01
期刊：
NEUROBIOLOGY OF ALZHEIMER'S DISEASE
影响因子：
--
作者：
Hoyer, S;Henneberg, N;Martin, E
通讯作者：
Martin, E
影响因子：
3
作者：
Isales, CM;Min, L;Hoffman, WH
通讯作者：
Hoffman, WH
影响因子：
6.3
作者：
Ennis, Stenten R.;Keep, Richard F.
通讯作者：
Keep, Richard F.
影响因子：
7.7
作者：
Glaser N;Yuen N;Anderson SE;Tancredi DJ;O'Donnell ME
通讯作者：
O'Donnell ME
影响因子：
7.7
作者：
Collino, Massimo;Aragno, Manuela;Castiglia, Sara;Tomasinelli, Chiara;Thiemermann, Christoph;Boccuzzi, Giuseppe;Fantozzi, Roberto
通讯作者：
Fantozzi, Roberto