Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes
Brain magnetic resonance imaging correlates of impaired cognition in patients with type 2 diabetes
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DOI：
10.2337/diabetes.55.04.06.db05-1323
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发表时间：
2006-04-01
期刊：
影响因子：
7.7
通讯作者：
Biessels, GJ
中科院分区：
文献类型：
--
作者：
Manschot, SM;Brands, AMA;Biessels, GJ
2型糖尿病认知功能受损的结构相关性尚不清楚。本研究比较了2型糖尿病患者和非糖尿病对照组的认知和脑磁共振成像（MRI）结果，并评估了认知和MRI结果与血压和代谢控制之间的关系。该研究包括113名患者和51名对照受试者。脑MRI扫描评估白质病变（WMLs）、皮质和皮质下萎缩以及梗死。神经心理学测试分数分为五个认知领域，并以标准化Z值表示。2型糖尿病与深部脑损伤（P = 0.02）、皮质（P < 0.001）和皮质下（P < 0.05）萎缩、（无症状）梗死（P = 0.06）以及认知能力受损（注意力和执行功能、信息处理速度和记忆，均P < 0.05）相关。高血压调整不影响结果。在2型糖尿病组中，认知功能与脑白质损伤、脑萎缩和脑梗死呈负相关；（根据年龄、性别和估计的智商进行调整），并且与HbA（1c）和糖尿病病程有一定的关联。这种关联在年龄上最为明显，甚至比对照组更明显。我们得出结论，2型糖尿病患者的认知障碍不仅与大脑皮层下缺血性改变有关，而且与脑萎缩增加有关。
The structural correlates of impaired cognition in type 2 diabetes are unclear. The present study compared cognition and brain magnetic resonance imaging (MRI) between type 2 diabetic patients and nondiabetic control subjects and assessed the relationship between cognition and MRI findings and blood pressure and metabolic control. The study included 113 patients and 51 control subjects. Brain MRI scans were rated for white matter lesions (WMLs), cortical and subcortical atrophy, and infarcts. Neuropsychological test scores were divided into five cognitive domains and expressed as standardized Z values. Type 2 diabetes was associated with deep WMLs (P = 0.02), cortical (P < 0.001) and subcortical (P < 0.05) atrophy, (silent) infarcts (P = 0.06), and impaired cognitive performance (attention and executive function, information-processing speed, and memory, all P < 0.05). Adjustment for hypertension did not affect the results. Within the type 2 diabetic group, cognitive function was inversely related with WMLs, atrophy, and the presence of infarcts; (adjusted for age, sex, and estimated IQ), and there was a modest association with HbA(1c) and diabetes duration. This association was strongest for age, even more so than in control subjects. We conclude that cognitive impairments in patients with type 2 diabetes are not only associated with subcortical ischemic changes in the brain, but also with increased brain atrophy.