Type 2 Diabetes in Adolescence, Cognition and the Brain

描述（由申请人提供）：随着肥胖在年轻人中的爆发，T2 DM在青少年中不再罕见。更好地了解T2 DM对青少年大脑的影响非常重要，特别是在他们的学习能力和在学校的表现将极大地影响他们的未来的时候。这项初步研究的目的是仔细描述肥胖青少年T2 DM患者中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大脑底物。我们有初步数据显示T2 DM青少年的认知问题，初步数据表明白色完整性可能存在与糖尿病相关的异常，因此证明这些研究是合理的。利用病例对照设计，我们将研究两组各25名肥胖儿童，主要是少数民族，年龄在16至19岁之间，65%为女性。一般来说，T2 DM儿童的诊断时间为1-4年。对照组葡萄糖耐量正常，无显著胰岛素抵抗（IR），肥胖、年龄、种族（人种）和性别与T2 DM患者1：1匹配。我们将使用一个精心挑选的，基础广泛的，相对简短的电池良好的标准化神经心理测试与年龄和教育规范。此外，MRI脑部评价将使用完善的程序。我们对本研究中提出的所有评价都有相当丰富的经验。拟议的工作将提供关键的初步数据，以证明更全面的评估与儿童肥胖相关的代谢紊乱的大脑。这种更好的理解可能表明，大脑被正式评估为糖尿病潜在并发症的部位，并提供设计更积极的预防和干预计划所需的数据，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.