PDF(Pubmed)
Abstract：
BACKGROUND: Dysfunction of the glymphatic system in the brain in different stages of altered glucose metabolism and its influencing factors are not well characterized.
OBJECTIVE: To investigate the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states, the present study employed diffusion tensor imaging along the perivascular space (DTI-ALPS) index.
METHODS: Sample size was calculated using the pwr package in R software. This cross-sectional study enrolled 22 patients with normal glucose metabolism (NGM), 20 patients with prediabetes, and 22 patients with type 2 diabetes mellitus (T2DM). A 3.0T magnetic resonance imaging was used to evaluate the function of the glymphatic system. The mini-mental state examination (MMSE) was used to assess general cognitive function. The DTI-ALPS index of bilateral basal ganglia and the mean DTI-ALPS index was calculated. Further, the correlation between DTI-ALPS and clinical features was assessed.
RESULTS: The left-side, right-side, and mean DTI-ALPS index in the T2DM group were significantly lower than that in the NGM group. The right-side DTI-ALPS and mean DTI-ALPS index in the T2DM group were significantly lower than those in the prediabetes group. DTI-ALPS index lateralization was not observed. The MMSE score in the T2DM group was significantly lower than that in the NGM and prediabetes group. After controlling for sex, the left-side DTI-ALPS and mean DTI-ALPS index in the prediabetes group were positively correlated with 2-hour postprandial blood glucose level; the left-side DTI-ALPS index was negatively correlated with total cholesterol and low-density lipoprotein level. The right-side DTI-ALPS and mean DTI-ALPS index were negatively correlated with the glycosylated hemoglobin level and waist-to-hip ratio in the prediabetes group. The left-side, right-side, and mean DTI-ALPS index in the T2DM group were positively correlated with height. The left-side and mean DTI-ALPS index in the T2DM group were negatively correlated with high-density lipoprotein levels.
CONCLUSIONS: Cerebral glymphatic system dysfunction may mainly occur in the T2DM stage. Various clinical variables were found to affect the DTI-ALPS index in different glucose metabolism states. This study enhances our understanding of the pathophysiology of diabetic brain damage and provides some potential biological evidence for its early diagnosis.
OBJECTIVE: To investigate the function of the glymphatic system and its clinical correlates in patients with different glucose metabolism states, the present study employed diffusion tensor imaging along the perivascular space (DTI-ALPS) index.
METHODS: Sample size was calculated using the pwr package in R software. This cross-sectional study enrolled 22 patients with normal glucose metabolism (NGM), 20 patients with prediabetes, and 22 patients with type 2 diabetes mellitus (T2DM). A 3.0T magnetic resonance imaging was used to evaluate the function of the glymphatic system. The mini-mental state examination (MMSE) was used to assess general cognitive function. The DTI-ALPS index of bilateral basal ganglia and the mean DTI-ALPS index was calculated. Further, the correlation between DTI-ALPS and clinical features was assessed.
RESULTS: The left-side, right-side, and mean DTI-ALPS index in the T2DM group were significantly lower than that in the NGM group. The right-side DTI-ALPS and mean DTI-ALPS index in the T2DM group were significantly lower than those in the prediabetes group. DTI-ALPS index lateralization was not observed. The MMSE score in the T2DM group was significantly lower than that in the NGM and prediabetes group. After controlling for sex, the left-side DTI-ALPS and mean DTI-ALPS index in the prediabetes group were positively correlated with 2-hour postprandial blood glucose level; the left-side DTI-ALPS index was negatively correlated with total cholesterol and low-density lipoprotein level. The right-side DTI-ALPS and mean DTI-ALPS index were negatively correlated with the glycosylated hemoglobin level and waist-to-hip ratio in the prediabetes group. The left-side, right-side, and mean DTI-ALPS index in the T2DM group were positively correlated with height. The left-side and mean DTI-ALPS index in the T2DM group were negatively correlated with high-density lipoprotein levels.
CONCLUSIONS: Cerebral glymphatic system dysfunction may mainly occur in the T2DM stage. Various clinical variables were found to affect the DTI-ALPS index in different glucose metabolism states. This study enhances our understanding of the pathophysiology of diabetic brain damage and provides some potential biological evidence for its early diagnosis.
摘要：
背景：在糖代谢改变的不同阶段，大脑中淋巴系统的功能障碍及其影响因素尚未得到很好的表征。
目的：探讨不同糖代谢状态患者的淋巴系统功能及其临床相关性，本研究采用血管周围间隙弥散张量成像(DTI-ALPS)指数.
方法：使用R软件中的pwr软件包计算样品大小。这项横断面研究纳入了22例糖代谢正常（NGM）的患者，20名糖尿病前期患者，2型糖尿病(T2DM)患者22例。3.0T磁共振成像用于评估淋巴系统的功能。简易精神状态检查（MMSE）用于评估一般认知功能。计算双侧基底节DTI-ALPS指数及平均DTI-ALPS指数。Further,评估了DTI-ALPS与临床特征之间的相关性.
结果：左侧，右侧,T2DM组DTI-ALPS指数均显著低于NGM组。T2DM组右侧DTI-ALPS和平均DTI-ALPS指数明显低于糖尿病前期组。未观察到DTI-ALPS指数侧向化。T2DM组MMSE评分显著低于NGM和糖尿病前期组。在控制性行为后，糖尿病前期组左侧DTI-ALPS和平均DTI-ALPS指数与餐后2小时血糖水平呈正相关;左侧DTI-ALPS指数与总胆固醇和低密度脂蛋白水平呈负相关.糖尿病前期组右侧DTI-ALPS和平均DTI-ALPS指数与糖化血红蛋白水平和腰臀比呈负相关。左边,右侧,T2DM组平均DTI-ALPS指数与身高呈正相关。T2DM组左侧及平均DTI-ALPS指数与高密度脂蛋白水平呈负相关。
结论：脑淋巴系统功能障碍可能主要发生在T2DM阶段。发现各种临床变量在不同的葡萄糖代谢状态下影响DTI-ALPS指数。这项研究增强了我们对糖尿病脑损伤的病理生理学的理解，并为其早期诊断提供了一些潜在的生物学证据。
目的：探讨不同糖代谢状态患者的淋巴系统功能及其临床相关性，本研究采用血管周围间隙弥散张量成像(DTI-ALPS)指数.
方法：使用R软件中的pwr软件包计算样品大小。这项横断面研究纳入了22例糖代谢正常（NGM）的患者，20名糖尿病前期患者，2型糖尿病(T2DM)患者22例。3.0T磁共振成像用于评估淋巴系统的功能。简易精神状态检查（MMSE）用于评估一般认知功能。计算双侧基底节DTI-ALPS指数及平均DTI-ALPS指数。Further,评估了DTI-ALPS与临床特征之间的相关性.
结果：左侧，右侧,T2DM组DTI-ALPS指数均显著低于NGM组。T2DM组右侧DTI-ALPS和平均DTI-ALPS指数明显低于糖尿病前期组。未观察到DTI-ALPS指数侧向化。T2DM组MMSE评分显著低于NGM和糖尿病前期组。在控制性行为后，糖尿病前期组左侧DTI-ALPS和平均DTI-ALPS指数与餐后2小时血糖水平呈正相关;左侧DTI-ALPS指数与总胆固醇和低密度脂蛋白水平呈负相关.糖尿病前期组右侧DTI-ALPS和平均DTI-ALPS指数与糖化血红蛋白水平和腰臀比呈负相关。左边,右侧,T2DM组平均DTI-ALPS指数与身高呈正相关。T2DM组左侧及平均DTI-ALPS指数与高密度脂蛋白水平呈负相关。
结论：脑淋巴系统功能障碍可能主要发生在T2DM阶段。发现各种临床变量在不同的葡萄糖代谢状态下影响DTI-ALPS指数。这项研究增强了我们对糖尿病脑损伤的病理生理学的理解，并为其早期诊断提供了一些潜在的生物学证据。
