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Abnormal cerebral blood flow and brain function in type 2 diabetes mellitus

  • Original Article
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Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Type 2 diabetes mellitus (T2DM) lead to impaired cerebral blood perfusion, which leads to changes in brain function and affects the cognitive function of patients. In this study, cerebral blood flow (CBF) was used to evaluate the effect of T2DM on cerebral perfusion, and functional connectivity (FC) analysis was further used to explore whether the FC between the abnormal CBF region and the whole brain was changed. In addition, amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) were used to investigate the changes in spontaneous activity and connectivity strength of the brain network.

Methods

We recruited 40 T2DM patients and 55 healthy controls (HCs). They underwent 3D-T1WI, rs-fMRI, arterial spin labeling (ASL) sequence scans and a series of cognitive tests. Cognitive test scores and brain imaging indicators were compared between the two groups, and the relationships among laboratory indicators, cognitive test scores, and brain imaging indicators were explored in the T2DM group.

Results

Compared to HCs, The CBF values of Calcarine_L and Precuneus_R in the T2DM group were lower. The DC value of Paracentral_Lobule_L and Precuneus_L, and the ALFF value of Hippocampus_L in the T2DM group were higher. In addition, the CBF values of Calcarine_L was negatively correlated with fasting insulin and HOMA_IR.

Conclusion

This study found that there were regions of cerebral hypoperfusion in T2DM patients, which are associated with insulin resistance. In addition, we found abnormally elevated brain activity and enhanced functional connectivity in T2DM patients, which we speculated was the compensatory mechanism of brain neural activity.

Highlights

  • T2DM patients have long-term metabolic disorders that affect brain function, thus leading to the occurrence and development of cognitive impairment.

  • CBF reflects blood perfusion in the brain. ALFF and DC reflect brain local spontaneous activity and brain network connection intensity respectively.

  • The purpose of this study was to investigate the changes in brain function in T2DM patients and its relationship with cognitive impairment.

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Data availability

Some or all datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Abbreviations

Full name:

Abbreviation

Type 2 diabetes mellitus:

T2DM

Cerebral blood flow:

CBF

Functional connectivity:

FC

Amplitude of low-frequency fluctuation:

ALFF

Degree centrality:

DC

Arterial spin labeling:

ASL

Regions of interest:

ROI

Healthy controls:

HCs

Glycated hemoglobin:

HbA1c

Fasting blood glucose:

FBG

Fasting insulin:

FINS

Homeostatic model assessment for insulin resistance:

HOMA-IR

Montreal Cognitive Assessment:

MoCA

Auditory Language Learning Test:

AVLT

Digital Span Test:

DST

Clock Drawing Test:

CDT

Grooved Pegboard Test:

GPT

Age-related white matter change:

ARWMC

Gaussian random field:

GRF

Phosphatidylinositol 3-kinase:

PI3K

Alzheimer disease:

AD

Mild cognitive impairment:

MCI

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Funding

This study was supported by the Key International Cooperation Project of National Natural Science Foundation of China (Grant No. 81920108019) and National Natural Science Foundation for Young Scholars of China (Grant No. 82104698). Y.L. was supported by Excellent Doctoral Dissertation Incubation Grant of First Clinical School of Guangzhou University of Chinese Medicine (YB202003).

Author information

Author notes

  1. These authors contributed equally: Mingrui Li, Yifan Li.

  2. These authors jointly supervised this work: Shijun Qiu, Xin Tan, Yi Liang.

Authors and Affiliations

  1. First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China

    Mingrui Li, Yifan Li, Kui Zhao, Yuna Chen, Yujie Liu, Shijun Qiu & Yi Liang

  2. Department of Radiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

    Mingrui Li, Yifan Li, Kui Zhao, Chunhong Qin, Yuna Chen, Yujie Liu, Shijun Qiu, Xin Tan & Yi Liang

  3. Department of Magnatic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine, Zhanjiang, China

    Mingrui Li

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Contributions

M.L. and Y.Li designed this study and wrote the manuscript. K.Z. contributed to the statistical analysis. C.Q. administered the neuropsychological tests. Y.C. and Y.Liu did the data analysis and amended the manuscript. S.Q., X.T. and Y.Liang are the guarantors of this study and chiefly responsible for the whole process of the experiment.

Corresponding authors

Correspondence to Shijun Qiu, Xin Tan or Yi Liang.

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The authors declare no competing interests.

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Written informed consent was obtained from all individual participants included in the study.

Ethics approval

This study was approved by the Medical Research Ethics Committee of Guangzhou University of Chinese Medicine.

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Li, M., Li, Y., Zhao, K. et al. Abnormal cerebral blood flow and brain function in type 2 diabetes mellitus. Endocrine (2023). https://doi.org/10.1007/s12020-023-03342-6

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