Type 2 diabetes mellitus is associated with brain atrophy and hypometabolism in the ADNI cohort
Type 2 diabetes mellitus is associated with brain atrophy and hypometabolism in the ADNI cohort
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DOI：
10.1212/wnl.0000000000002950
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发表时间：
2016-08-09
期刊：
影响因子：
9.9
通讯作者：
Saykin, Andrew J.
中科院分区：
文献类型：
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作者：
Li, Wei;Risacher, Shannon L.;Saykin, Andrew J.
目的：我们研究了2型糖尿病（T2DM）作为脑萎缩和糖代谢低下的危险因素在有或有认知障碍风险的老年人中。方法：从阿尔茨海默病神经影像学倡议（ADNI-1/GO/2队列）中确定T2DM患者。采用协方差模型分析比较T2DM患者和非T2DM患者，控制潜在的混杂因素。结果：全脑容量和全脑[F-18]-氟脱氧葡萄糖（FDG）摄取作为T2DM状态的函数有显著差异，与基线临床诊断无关。事后分析显示，轻度认知障碍（MCI）和T2DM患者的全脑容量（n= 76）比轻度认知障碍（MCI）但非T2DM患者的全脑容量（n=747; p=0.009）更低。同样，患有轻度认知损伤和T2DM的参与者（n=72）的灰质和白质中FDG的平均摄取低于患有轻度认知损伤而没有T2DM的参与者（n=719; p=0.04）。随后的区域分析显示，MCI和T2DM参与者的FDG摄取减少主要表现在3个脑区：额叶、感觉运动皮层和纹状体。结论：T2DM可能通过影响糖代谢和脑容量加速轻度认知损伤患者的认知退化。
Objective: We investigated type 2 diabetes mellitus (T2DM) as a risk factor for brain atrophy and glucose hypometabolism in older adults with or at risk of cognitive impairment.Methods: Participants with the T2DM were identified from the Alzheimer's Disease Neuroimaging Initiative (ADNI-1/GO/2 cohorts). Analysis of covariance models were used to compare participants with and without T2DM, controlling for potential confounding factors.Results: Whole brain volume and whole brain [F-18]-fluorodeoxyglucose (FDG) uptake were significantly different as a function of T2DM status, independent of baseline clinical diagnosis. On post hoc analysis, a lower whole brain volume was seen in participants with both mild cognitive impairment (MCI) and T2DM (n = 76) compared with participants who had MCI but not T2DM (n=747; p=0.009). Similarly, mean FDG uptake in gray matter and white matter was lower in participants with both MCI and T2DM (n=72) than in participants with MCI without T2DM (n=719; p=0.04). Subsequent regional analysis revealed that the decreased FDG uptake in participants with both MCI and T2DM was mainly manifested in 3 brain regions: frontal lobe, sensory motor cortex, and striatum.Conclusions: T2DM may accelerate cognition deterioration in patients with MCI by affecting glucose metabolism and brain volume.