Type 2 Diabetes in Adolescence, Cognition and the Brain

描述（由申请人提供）：随着年轻人肥胖的激增，T2DM在青少年中不再罕见。重要的是要更好地了解2型糖尿病对青少年大脑的影响，特别是在他们的学习能力和在学校的良好表现将对他们的未来产生重大影响的时候。本初步研究的目的是仔细描述肥胖青少年2型糖尿病患者可能存在的认知障碍的性质，并使用基于mri的方法探索这些缺陷背后可能的脑底物。我们有初步数据显示青少年2型糖尿病患者存在认知问题，初步数据显示可能存在与糖尿病相关的白质完整性异常，因此证明了这些研究的合理性。采用病例对照设计，我们将研究两组肥胖儿童，每组25名，主要为少数民族，年龄在16至19岁之间，65%为女性。一般来说，患有2型糖尿病的儿童会在1-4年被诊断出来。对照者葡萄糖耐量正常，无明显胰岛素抵抗（IR），肥胖、年龄、种族和性别与2型糖尿病患者的比例为1:1。我们将利用精心挑选的、基础广泛的、相对简短的、具有年龄和教育标准的标准化神经心理学测试。此外，核磁共振脑评估将使用完善的程序。我们对本研究中提出的所有评估都有相当的经验。这项提议的工作将提供关键的初步数据，为更全面地评估与儿童肥胖相关的大脑代谢紊乱提供依据。这一改进的认识可能表明，大脑被正式评估为糖尿病潜在并发症的一个部位，并提供所需的数据，以设计更积极的预防和干预计划，旨在改善年轻人的大脑功能。

DESCRIPTION (provided by applicant): With the explosion of obesity among the young, T2DM is no longer rare among adolescents. It is important to better understand the effects of T2DM on the brain of adolescents, particularly at a time when their ability to learn and do well in school will greatly impact their future. The objective of this pilot study is to carefully characterize the nature of the cognitive impairments that are likely present among obese adolescents with T2DM and to use an MRI-based approach to explore the possible brain substrates underlying those deficits. We have pilot data showing cognitive problems in adolescents with T2DM and preliminary data suggesting that there may be abnormalities in white matter integrity associated with diabetes, thus justifying these studies. Utilizing a case-control design, we will study two groups of 25 obese children each, predominantly ethnic minority, between 16 and 19 years of age, and 65% female. In general the children with T2DM will have been diagnosed for 1-4 years. Controls will have normal glucose tolerance and no significant insulin resistance (IR) and be matched 1:1 for obesity, age, ethnicity (race), and gender to those with T2DM. We will utilize a carefully selected, broad-based, and relatively brief battery of well-standardized neuropsychological tests with age and education norms. In addition, the MRI brain evaluation will use well-established procedures. We have considerable experience with all the evaluations proposed in this study. The proposed work will provide the key preliminary data to justify a more comprehensive assessment of the brain in metabolic disorders associated with obesity in childhood. This improved understanding may suggest that the brain be formally evaluated as a site of potential complications in diabetes and provide the data needed to design more aggressive prevention and intervention programs aimed at improving brain function among the young.