| BackgroundType 2 diabetes can cause cognitive impairment through chronic hyperglycemia and insulin resistance,which can accelerate the development of cognitive impairment to dementia.The study found that in people with diabetes that the proportion of patients with type 2 diabetes is quite large,and their cognitive impairment was more common.It was found that the degree of brain white matter injury in patients was correlated with the decline of cognitive function.But it is about a middle-aged type 2 patients in the study of cognitive function and cerebral white matter changes little.To explore the function cognitiveand structure of white matter in middle-aged patients with type 2 patients,which may contribute to the development of preventive interventions to reduce cognitive decline.Objective1.The present study examines the cognitive function of patients with middle-age type 2 diabetes.2.To investigate the changes of white matter integrity in patients with middle-age type 2 diabetes mellitus and its correlation with cognitive function and clinical indicators.Methods1.40 patients with type 2 diabetes were selected as the research group,the average age was 48.7±4.49 years old.40 non diabetic patients matched at the same age,sex and educational level were used as the control group,the average age is 48.65±5.05 years old.In a relaxed and quite nvironment all subjects received a series of neuropsychological tests such as trail-making test,montrealcognitive assessment,digit span test,Verbal fluency test,auditory Verbal learing test to evaluate their cognitive function.To collect all the subjects' s the general clinical data and to determine the biochemical indexes of the blood.The clinical data included age,sex,level of education,blood pressure,smoking and drinking,and biochemical indicators including Fasting blood glucose,glycatedhemoglobin,totalcholesterol,glyceride,low-densitylipoprotein and high-density lipoprotein.2.We used GE Corporation 3.0-tesla MRIscanner to collect T1 WI and T2 FLAIR weighted images,and to obtain DTI.The partial anisotropy(fractional anisotropy,FA)of two groups of whole brain white matter(FA)was compared by voxel based analysis.Pearson correlation analysis was used to evaluate the correlation between the average FA value of the brain area and the clinical index and cognitive function score of type 2 diabetes group.Results1.There was no significant differenceage in sex,blood pressure,blood lipid,smoking,drinking and the number of years of education sex,age in type 2 diabetes and control group(P > 0.05).2.The scores of MoCA,TMT-B and AVLT-RC In the diabetes groupwere significantly lower than those in the control group,theirs fasting blood glucose and glycosylated hemoglobin were significantly higher than that of control group,and the difference have statistical significance(P < 0.01).3.Compared with the control group,the FA values of the left,right frontal lobes and the center of the oval circle in the type 2 diabetes group were significantly lower than those in the control group,and the difference was statistically significant(P < 0.01).4.The FA value of bilateral frontal lobes in type 2 diabetes group was positively correlatedwith the total score of MoCA((left: r=0.402,P <0.05,right: r=0.513,P <0.01)5.The FA value of white matter in bilateral frontal lobe and central white matter of hemioval in type 2 diabetes group was negatively correlated with glycosylated hemoglobin(left frontal lobe: r=-0.369,P <0.05;right frontal lobe:r=-0.376,P <0.05;left centrum ovale:r=-0.378,P <0.05;right frontal lobe: r=-0.483,P <0.01).Conclusions1.There are multiple cognitive impairment in the middle-aged type 2 diabetespatients,which is mainly with executive dysfunction,delayed memory,and attentional decline.2.Type 2 diabetes patients have the destruction of white matter integrity,and these microstructural injuries may be the underlying neural mechanisms that lead to cognitive impairment in patients with type 2 patients.3.Chronic hyperglycemia may be an important factor leading to the loss of white matter integrity in patients with type 2 patients. |
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