PDF(Pubmed)
Abstract：
Background: Since metabolic diseases and atherosclerotic vascular events are firmly associated, herein we investigate changes in central microcirculation and atherosclerosis-related body fat distribution in patients with type 2 diabetes mellitus and obesity. Methods: Resting brain perfusion single-photon emission computed tomography (SPECT) imaging with Technetium-99m hexamethylpropylene amine oxime ([99mTc]Tc-HMPAO SPECT) was performed, and the breath-holding index (BHI) and carotid intima-media thickness (cIMT) were measured to characterise central microcirculation. Besides CT-based abdominal fat tissue segmentation, C-peptide level, glycaemic and anthropometric parameters were registered to search for correlations with cerebral blood flow and vasoreactivity. Results: Although no significant difference was found between the resting cerebral perfusion of the two patient cohorts, a greater blood flow increase was experienced in the obese after the breath-holding test than in the diabetics (p < 0.05). A significant positive correlation was encountered between resting and provocation-triggered brain perfusion and C-peptide levels (p < 0.005). BMI and cIMT were negatively correlated (rho = -0.27 and -0.23 for maximum and mean cIMT, respectively), while BMI and BHI showed a positive association (rho = 0.31 and rho = 0.29 for maximum and mean BHI, respectively), which could be explained by BMI-dependent changes in fat tissue distribution. cIMT demonstrated a disproportional relationship with increasing age, and higher cIMT values were observed for the men. Conclusions: Overall, C-peptide levels and circulatory parameters seem to be strong applicants to predict brain microvascular alterations and related cognitive decline in such patient populations.
摘要：
背景：由于代谢性疾病和动脉粥样硬化血管事件密切相关，本文研究了2型糖尿病和肥胖患者中枢微循环和动脉粥样硬化相关体脂分布的变化。方法：采用Tech-99m六甲基丙烯胺肟（[99mTc]Tc-HMPAOSPECT）进行静息脑灌注单光子发射计算机断层扫描（SPECT）成像，测量屏气指数（BHI）和颈动脉内中膜厚度（cIMT）以表征中央微循环。除了基于CT的腹部脂肪组织分割，C肽水平，记录血糖和人体测量参数，以搜索与脑血流量和血管反应性的相关性。结果：尽管两个患者队列的静息脑灌注之间没有发现显着差异，与糖尿病患者相比,屏气试验后肥胖者的血流量增加更大(p<0.05).静息和激发触发的脑灌注与C肽水平之间存在显着正相关（p<0.005）。BMI和cIMT呈负相关（最大和平均cIMT的rho=-0.27和-0.23，分别)，而BMI和BHI显示出正相关（最大和平均BHI的rho=0.31和rho=0.29，分别)，这可以解释为脂肪组织分布的BMI依赖性变化。cIMT表现出与年龄增长不成比例的关系，男性的cIMT值较高。结论：总体而言，C肽水平和循环参数似乎是预测此类患者人群中脑微血管改变和相关认知下降的有力应用。
