Modifiers of cognitive function and brain structure in middle-aged and elderly individuals with type 2 diabetes mellitus.
Modifiers of cognitive function and brain structure in middle-aged and elderly individuals with type 2 diabetes mellitus.
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DOI：
10.1016/j.brainres.2009.05.032
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发表时间：
2009-07-14
期刊：
影响因子：
2.9
通讯作者：
Convit A
中科院分区：
文献类型：
--
作者：
Bruehl H;Wolf OT;Sweat V;Tirsi A;Richardson S;Convit A
2型糖尿病（T2DM）中描述了认知缺陷和海马萎缩（与衰老和痴呆共有的特征）。T2DM与肥胖、高血压、血脂异常、下丘脑垂体肾上腺皮质（HPA）轴异常和炎症相关，所有这些均显示对大脑产生负面影响。然而，由于T2DM的大多数报告关注血糖控制，因此这些修饰因子对T2DM中观察到的损害的相对贡献仍不清楚。我们对比了41名中年无痴呆症的T2DM志愿者（自诊断以来平均7年）与47名年龄，教育和性别匹配的非胰岛素抵抗对照组的认知和脑容量。评估HPA轴活性和伴随T2DM的其他修饰物，以确定其对大脑和认知的影响。2型糖尿病患者有特定的语言陈述性记忆缺陷，海马和前额叶体积减少，HPA轴反馈控制受损。地塞米松和血脂异常后皮质醇抑制减少与认知能力下降相关，而肥胖与海马体积呈负相关。此外，前额叶体积受血糖控制不良的影响。因此，肥胖和皮质醇水平改变可能有助于T2DM对海马结构的影响，导致言语陈述性记忆表现下降。
Cognitive deficits and hippocampal atrophy, features that are shared with aging and dementia, have been described in type 2 diabetes mellitus (T2DM). T2DM is associated with obesity, hypertension, dyslipidemia, hypothalamic pituitary adrenocortical (HPA) axis abnormalities and inflammation, all of which have been shown to negatively impact the brain. However, since most reports in T2DM focused on glycemic control, the relative contribution of these modifying factors to the impairments observed in T2DM remains unclear. We contrasted 41 middle-aged dementia-free volunteers with T2DM (on average 7 years since diagnosis) with 47 age-, education-, and gender-matched non-insulin resistant controls on cognition and brain volumes. HPA axis activity and other modifiers that accompany T2DM were assessed to determine their impact on brain and cognition. Individuals with T2DM had specific verbal declarative memory deficits, reduced hippocampal and prefrontal volumes, and impaired HPA axis feedback control. Diminished cortisol suppression after dexamethasone and dyslipidemia were associated with decreased cognitive performance, whereas obesity was negatively related to hippocampal volume. Moreover, prefrontal volume was influenced by worse glycemic control. Thus, obesity and altered cortisol levels may contribute to the impact of T2DM on the hippocampal formation, resulting in decreased verbal declarative memory performance.
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DOI：
10.1093/gerona/60.4.471
发表时间：
2005-04-01
影响因子：
5.1
作者：
Beeri, MS;Silverman, JM;Haroutunian, V
通讯作者：
Haroutunian, V
影响因子：
5.8
作者：
Haltia, Lauri T.;Viljanen, Antti;Kaasinen, Valtteri
通讯作者：
Kaasinen, Valtteri
DOI：
10.1017/s1355617704104165
发表时间：
2004-07-01
影响因子：
2.6
作者：
Hassing, LB;Grant, MD;Johansson, B
通讯作者：
Johansson, B
影响因子：
8.3
作者：
Beason-Held, Lori L.;Moghekar, Abhay;Resnick, Susan M.
通讯作者：
Resnick, Susan M.
影响因子：
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作者：
Jagust, W;Harvey, D;Haan, M
通讯作者：
Haan, M