Structural and functional alterations of the hippocampal subfields in T2DM with mild cognitive impairment and insulin resistance: A prospective study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-11-13 DOI:10.1111/1753-0407.70029

Chen Yang, Huiyan Zhang, Zihan Ma, Yanjun Fan, Yanan Xu, Jian Tan, Jing Tian, Jiancang Cao, Wenwen Zhang, Gang Huang, Lianping Zhao

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Abstract

Background

Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and is often accompanied by mild cognitive impairment (MCI). The detrimental effects of T2DM and IR on the hippocampus have been extensively demonstrated. Few studies have examined the effects of IR on structure and function of hippocampal subfields in T2DM-MCI patients.

Method

A total of 104 T2DM patients were recruited in this prospective study and divided into four groups (T2DM-MCI-higherIR, n = 17; T2DM-MCI-lowerIR, n = 32; T2DM-nonMCI-higherIR, n = 19; T2DM-nonMCI-lowerIR, n = 36). Structure and function MRI data were captured. Clinical variables and neuropsychological scores were determined for all participants. Hippocampal subfield volume and functional connectivity were compared among four groups. Partial correlation analysis was performed between imaging indicators, clinical variables, and neuropsychological scores in all patients.

Results

T2DM-MCI-higher IR group had the smallest volumes of bilateral hippocampal tail, right subiculum-body, right GC-ML-DG-body, and right CA4-body. IR in right hippocampal tail, right subiculum-body, and right GC-ML-DG-body exerted main effect. Furthermore, elevated functional connectivity was found between right subiculum-body and bilateral dorsolateral prefrontal cortex and right anterior cingulate–medial prefrontal cortex. Hippocampal subfield volume positively correlates with total cholesterol and triglycerides and negatively correlates with fasting insulin.

Conclusion

The present study found that T2DM-MCI patients have structural and functional alterations in hippocampal subfields, and IR is a negative factor influencing the alteration of hippocampal subfields volume. These findings support the importance of IR in T2DM-MCI patients and might be potential neuroimaging biomarkers of cerebral impairment in T2DM-MCI patients.

Abstract Image

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伴有轻度认知障碍和胰岛素抵抗的 T2DM 患者海马亚区的结构和功能改变：一项前瞻性研究

背景：2 型糖尿病（T2DM）以胰岛素抵抗（IR）为特征，通常伴有轻度认知障碍（MCI）。T2DM 和 IR 对海马的有害影响已得到广泛证实。很少有研究探讨 IR 对 T2DM-MCI 患者海马亚区结构和功能的影响：方法：这项前瞻性研究共招募了104名T2DM患者，并将其分为四组（T2DM-MCI-高IR组，n = 17；T2DM-MCI-低IR组，n = 32；T2DM-非MCI-高IR组，n = 19；T2DM-非MCI-低IR组，n = 36）。采集了结构和功能磁共振成像数据。确定了所有参与者的临床变量和神经心理学评分。比较了四组患者的海马亚区体积和功能连通性。对所有患者的成像指标、临床变量和神经心理学评分进行了部分相关性分析：结果：T2DM-MCI-高IR组的双侧海马尾部、右侧子丘体、右侧GC-ML-DG体和右侧CA4体的体积最小。右侧海马尾部、右侧子网体和右侧GC-ML-DG体的IR具有主效应。此外，还发现右侧子房体与双侧背外侧前额叶皮层和右侧前扣带回-内侧前额叶皮层之间的功能连接性增强。海马亚区体积与总胆固醇和甘油三酯呈正相关，与空腹胰岛素呈负相关：本研究发现，T2DM-MCI 患者的海马亚区存在结构和功能改变，而 IR 是影响海马亚区体积改变的负性因素。这些发现支持了IR在T2DM-MCI患者中的重要性，并可能成为T2DM-MCI患者脑损伤的潜在神经影像生物标志物。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.