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Alteration of brain functional connectivity strength in patients with type 2 diabetes and its neuropathological mechanism
- Medical Journal of Chinese People′s Liberation Army Vol. 48, Issue 11, Pages: 1321-1327(2023)
- 作者机构：
1.甘肃省人民医院放射科，甘肃兰州 730000
- 作者简介：
E-mail: lianping_zhao007@163.com
- 基金信息：the National Natural Science Foundation of China(81901724;81860306);the Natural Science Foundation of Gansu Province(20JR5RA156;21JR7RA593);the Scientific Research Fund of Gansu Provincial People`s Hospital(19SYPYA-2)
DOI：10.11855/j.issn.0577-7402.1265.2023.0403
CLC：
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陆亚姗, 赵莲萍, 黄刚, 等. 2型糖尿病患者脑功能连接强度的改变及其神经病理机制[J]. 解放军医学杂志, 2023, 48(11): 1321-1327.
Lu Ya-Shan,Zhao Lian-Ping,Huang Gang,et al.Alteration of brain functional connectivity strength in patients with type 2 diabetes and its neuropathological mechanism[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1321-1327.
陆亚姗, 赵莲萍, 黄刚, 等. 2型糖尿病患者脑功能连接强度的改变及其神经病理机制[J]. 解放军医学杂志, 2023, 48(11): 1321-1327. DOI： 10.11855/j.issn.0577-7402.1265.2023.0403.
Lu Ya-Shan,Zhao Lian-Ping,Huang Gang,et al.Alteration of brain functional connectivity strength in patients with type 2 diabetes and its neuropathological mechanism[J].Medical Journal of Chinese People′s Liberation Army,2023,48(11):1321-1327. DOI： 10.11855/j.issn.0577-7402.1265.2023.0403.
摘要
目的,2,探讨2型糖尿病(T2DM)患者脑功能连接强度的改变及其神经病理机制。,方法,2,选取2017年10月－2021年3月在甘肃省人民医院就诊的56例T2DM患者为T2DM组，另选择48例健康对照者为对照组，采用静息态脑功能连接强度(FCS)和基于种子点的功能连接(FC)分析方法对T2DM患者脑功能改变进行前瞻性研究。两组均进行脑部功能磁共振扫描、临床变量采集及神经心理学测试；计算FCS值，评估静息状态下两组脑功能的变化，以组间差异显著的脑区为种子点与全脑行功能连接分析，并提取差异脑区的FCS及FC值，与空腹血糖(FPG)、糖化血红蛋白(HbA,1c,)、促甲状腺激素(TSH)水平等临床变量以及简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、画钟测验(CDT)、汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)评分行相关性分析。,结果,2,与对照组比较，T2DM组HAMD-24、HAMA评分明显升高(,P,<,0.01)，MoCA评分降低(,P,<,0.05)；T2DM组右侧颞中回FCS值升高(GRF矫正，体素水平,P,<,0.001，集簇水平,P,<,0.05)，且右侧颞中回-左侧前扣带皮质间FC值降低(GRF矫正，体素水平,P,<,0.001，集簇水平,P,<,0.05)。相关性分析显示，T2DM患者右侧颞中回-左侧前扣带皮质间FC值与HAMD-24评分(,r,=-0.395，,P,=0.003)、HbA,1c,水平(,r,=-0.303，,P,=0.023)呈负相关，与TSH水平呈正相关(,r,=0.324，,P,=0.017)。,结论,2,T2DM患者右侧颞中回FCS值升高，右侧颞中回-左侧前扣带皮质间FC值降低，可能是T2DM患者脑功能损害的重要神经影像学特征。HbA,1c,可能在T2DM患者脑损害过程中起重要作用。
Abstract
Objective,2,To explore the change of brain functional connectivity strength in patients with type 2 diabetes mellitus (T2DM) and its neuropathological mechanism.,Methods,2,Fifty-six T2DM patients who visited Gansu Provincial Hospital from October 2017 to March 2021 were selected as T2DM group, and 48 healthy controls were selected as control group. A prospective study was conducted on the changes in brain function in T2DM patients by analysis of resting state functional connectivity strength (FCS) and functional connectivity (FC) based on seed points. Brain functional magnetic resonance imaging, clinical variable collection, and neuropsychological testing of patients in two groups were performed. We calculate the FCS value, evaluate the brain function changes of the two groups in the resting state, take the brain regions with significant differences between the groups as the seed points and perform functional connectivity analysis with the whole brain. Correlation analysis was conducted between the FCS, FC values of the different brain regions and clinical variables such as fasting blood glucose (FPG), glycosylated hemoglobin (HbA,1c,), thyroid hormone (TSH) levels, as well as the scores of mini mental state examination (MMSE), Montreal cognitive assessment (MoCA), clock drawing test (CDT), Hamilton Depression Rating Scale (HAMD-24) and Hamilton Anxiety Scale (HAMA).,Results,2,Compared with control group, the HAMD-24 and HAMA scores in T2DM group significantly increased,(,P,<,0.01), while the MoCA scores decreased (,P,<,0.05); In T2DM group, the FCS value of the right middle temporal gyrus increased (GRF correction, voxel level ,P,<,0.001, clustering level ,P,<,0.05), and the FC value of the right middle temporal gyrus-left anterior cingulate cortex decreased (GRF correction, voxel level ,P,<,0.001, clustering level ,P,<,0.05). Correlation analysis showed that the FC value of right middle temporal gyrus-left anterior cingulate cortex in T2DM patients was negatively correlated with HAMD-24 score,(,r,=-0.395,P,=0.003), HbA,1c, level (,r,=-0.303,P,=0.023), and positively correlated with TSH level (,r,=0.324,P,=0.017).,Conclusions,2,The increase of FCS value in the right middle temporal gyrus and the decrease of FC value in the right middle temporal gyrus-left anterior cingulate cortex may be important neuroimaging features of brain function damage in T2DM patients. HbA,1c, may play an important role in the process of brain damage in T2DM patients.
关键词
糖尿病，2型磁共振成像功能连接强度认知障碍抑郁
Keywords
diabetes mellitus type 2magnetic resonance imagingfunctional connectivity strengthcognition disordersdepression
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