Changes And Correlations Of The Microstructure And Cognitive Function In Hemivertebra At Newly Diagnosed T2DM And IGT

1 Background and ObjectivesCurrently,diabetes has become one of the major diseases that threaten public health.In China,the incidence of diabetes mellitus(DM)has been increasing year by year.Type 2 diabetes(T2DM)accounts for about 90% of middle-aged and elderly DM patients.High blood glucose levels can cause cerebrovascular hardening,hemorrhage,the increased probability of ischemia,easily lead to vascular dementia,a small number of studies have shown that when T2 DM patients clinically lacking in significant vascular disease in the early manifestation may have been brain micro Structural changes and mild cognitive impairment(MCI).The microstructure and cognitive function of the newly diagnosed type 2 diabetes mellitus(T2DM)and impaired glucose tolerance(IGT)were measured by magnetic resonance diffusion tensor imaging(DTI)and the Monte Carlo scale(MoCA)And to explore the clinical significance of DTI and MoCA in assessing the changes of white matter structure in the semi-oval center of newly diagnosed T2 DM and IGT patients.2 Object and Methods Collect the general information of selected participants: record the status of each group such as sex ratio,age,body mass index(BMI);collect blood biochemistry and other clinical data: record glycosylated hemoglobin(HbA1C)(%),fasting blood glucose(FPG))Oral glucose tolerance test 2 hours blood glucose(OGTT 2 hours blood glucose),systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),etc.The results of the examination were collected;the DTI anisotropy values(FA)and MoCA scores of the semi-oval center of the left and right sides of the subjects were collected.SPSS 21.0 was used to analyze the inter-group differences and their correlations between general data,biochemical indicators,DTI data,and MoCA scores.3 Research Results 3.1 Comparison of general information of subjects(1)The body mass index(BMI)of the newly diagnosed T2 DM group was higher than that of the normal group(P <0.05),and there was no significant difference between the two groups(P> 0.05);(2)There was no significant difference between normal control group and normal control group(P> 0.05).(3)There was no significant difference in sex ratio and age between the three groups(P> 0.05).3.2 Subjects blood biochemical and other clinical indicators of comparison(1)The HbA1 c,FPG and OGTT2 h blood glucose and systolic blood pressure(SBP)in newly diagnosed T2 DM group were higher than those in newly diagnosed IGT group and normal control group(all P <0.05).The total cholesterol(TC)were higher than normal control group(P <0.05).(2)The FPG and OGTT2 h blood glucose levels in newly diagnosed IGT group were higher than those in normal group(all P <0.05).(3)There were no significant differences in DBP,TG and LDL-c between the three groups(P> 0.05).3.3 Comparison of subjects' DTI indices and MoCA scores(1)The scores of FAl,FAr and MoCA in the left and right sides of the newly diagnosed T2 DM group were lower than those in the normal control group(all P <0.05),but there was no significant difference between the two groups(P> 0.05);(2)There was no significant difference in FAl,FAr and MoCA scores between newly diagnosed IGT group and normal control group(all P> 0.05).3.4 Newly diagnosed T2 DM patients with general information,blood biochemistry and other data and the relevance of DTI indicatorsFAl in newly diagnosed T2 DM group was negatively correlated with BMI,HbA1 c,FPG,OGTT 2h blood glucose,SBP and TC(P was 0.01,0.024,0.019,0.048,0.038,0.045;r was-0.563,-0.503,-0.519,-0.448,-0.467,-0.452,respectively),but no correlated with DBP,TG,LDL-C(all P> 0.05).FAl in newly diagnosed T2 DM group was negatively correlated with BMI,HbA1 c,SBP,TC(P was 0.014,0.041,0.041,0.049;r was-0.541,-0.460,-0.460,-0.446),but no correlation with FPG,OGTT 2h blood glucose,DBP,TG and LDL-C(all P> 0.05).3.5 Correlation between DTI index and MoCA score in newly diagnosed T2 DM patientsThere was a positive correlation between FAl and MoCA scores in newly diagnosed T2 DM patients(P = 0.011,r = 0.556).There was no correlation between FAr and MoCA score in newly diagnosed T2 DM patients(P> 0.05).4 Conclusion 4.1 The newly diagnosed T2 DM patients with semi-oval center white matter FA ratio and MoCA score lower than normal,suggesting that newly diagnosed T2 DM patients in the absence of obvious abnormal MRI may have had white matter demyelination and mild cognitive decline There was no significant difference in FA scores and MoCA scores between IGT patients and normal subjects,suggesting that the microscopic structure and cognitive function of the newly diagnosed IGT patients may not be changed.4.2 BMI,HbA1 c,FPG,OGTT2 h blood glucose,SBP,TC may have different degrees of micro-structure of white matter;white matter microstructure lesions may be mild cognitive function Obstacle related;4.3 The application of DTI and MoCA can be used as a clinical test to detect changes in white matter and cognitive function in patients with early T2 DM.