Regional brain volume differences associated with hyperglycemia and severe hypoglycemia in youth with type 1 diabetes
Regional brain volume differences associated with hyperglycemia and severe hypoglycemia in youth with type 1 diabetes
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DOI：
10.2337/dc07-0351
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发表时间：
2007-09-01
期刊：
影响因子：
16.2
通讯作者：
Hershey, Tamara
中科院分区：
文献类型：
--
作者：
Perantie, Dana C.;Wu, Jenny;Hershey, Tamara
目的：尽管人们对1型糖尿病对发育中的大脑的影响很感兴趣，但患有这种疾病的青少年的结构脑容量以前没有被研究过。这项研究首次量化了大量青年糖尿病患者脑容量的区域差异。研究设计和方法：从7-17岁的青少年糖尿病患者（n = 108）和健康的兄弟姐妹对照（n = 51）中获得磁共振图像（MRls）。重度低血糖病史通过家长访谈评估，包括癫痫发作、意识丧失或需要协助治疗。诊断后的AIC值来源于病历；中位AIC按病程加权。基于体素的形态测定法用于确定先前低血糖和高血糖与整个大脑区域灰质和白质体积的关系。结果：糖尿病患者和健康对照组在灰质或白质方面没有发现显著差异。然而，在糖尿病组中，严重低血糖史与左侧颞上区灰质体积较小有关。高血糖暴露程度越高，右侧楔叶和楔前叶灰质体积越小，右侧后顶叶区域白质体积越小，右侧前额叶区域灰质体积越大。结论：在青少年1型糖尿病患者中，低血糖和高血糖与局部脑容量之间存在定性不同的关系。未来的研究应该调查这些差异是否与认知功能有关，以及这些区域如何受到进一步暴露的影响。
OBJECTIVE - Despite interest in the effects of type 1 diabetes on the developing brain, structural brain volumes in youth with this disease have not previously been examined. This study is the first to quantify regional brain volume differences in a large sample of youth with diabetes.RESEARCH DESIGN AND METHODS - Magnetic resonance images (MRls) were acquired from youth with diabetes (n = 108) and healthy sibling control subjects (n = 51) aged 7-17 years. History of severe hypoglycemia was assessed by parent interview and included seizure, loss of consciousness, or requiring assistance to treat. AIC values since diagnosis were obtained from medical records; median AIC was weighted by duration of disease. Voxel-based morphometry was used to determine the relationships of prior hypo- and hyperglycemia to regional grey and white matter volumes across the whole brain.RESULTS - No significant differences were found between diabetic and healthy control groups in grey or white matter. However, within the diabetic group, a history of severe hypoglycemia was associated with smaller grey matter volume in the left superior temporal region. Greater exposure to hyperglycemia was associated with smaller grey matter volume in the right cuneus and precuneus, smaller white matter volume in a right posterior parietal region, and larger grey matter volume in a right prefrontal region.CONCLUSIONS - Qualitatively different relationships were found between hypo- and hyperglycemia and regional brain volumes in youth with type 1 diabetes. Future studies should investigate whether these differences relate to cognitive function and how these regions are affected by further exposure.