[1]马藤,轩昂,张杰,等.2型糖尿病患者大脑静息葡萄糖代谢改变研究[J].国际放射医学核医学杂志,2018,(1):25-29.[doi:10.3760/cma.j.issn.1673-4114.2018.01.005]
　Ma Teng,Xuan Ang,Zhang Jie,et al.Changes in resting-state brain glucose metabolism in patients with type 2 diabetes[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(1):25-29.[doi:10.3760/cma.j.issn.1673-4114.2018.01.005]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第1期
页码:
25-29
栏目:
临床研究
出版日期:
2018-03-20

文章信息/Info

Title:
Changes in resting-state brain glucose metabolism in patients with type 2 diabetes
作者:
马藤;  轩昂;  张杰;  付畅;  孙萌萌;  尤阳;  徐俊玲
450000, 郑州大学人民医院PET/CT中心
Author(s):
Ma Teng;  Xuan Ang;  Zhang Jie;  Fu Chang;  Sun Mengmeng;  You Yang;  Xu Junling
PET/CT Center, the People’s Hospital of Zhengzhou University, Zhengzhou 450000, China
关键词:
糖尿病; 2型; 脑葡萄糖代谢; 氟脱氧葡萄糖F18; 正电子发射断层显像术; 体层摄影术; X线计算机; 统计参数地形图
Keywords:
Diabetes mellitus; type 2; Brain glucose metabolism; Fluorodeoxyglucose F18; Positron-emission tomography; Tomography; X-ray computed; Statistical parametric mapping
DOI:
10.3760/cma.j.issn.1673-4114.2018.01.005
摘要:
目的 探讨静息状态下2型糖尿病（T2DM）患者大脑葡萄糖代谢改变特点。方法 回顾性分析96例已被临床确诊的T2DM患者的头部18F-FDG PET/CT显像资料。选取96名健康体检者作为对照组。采用统计参数地形图8软件分析T2DM患者组与对照组PET脑代谢的改变。T2DM患者组与对照组图像采用体素对体素的两独立样本t检验。结果 与对照组比较，T2DM患者18F-FDG PET/CT表现为多个脑区的葡萄糖代谢减低（t=5.51~6.42，均P<0.001），主要包括双侧额中下回、双侧颞上横回、双侧枕上中舌回、双侧楔前叶、双侧顶下缘角回、距状裂及周围皮层；未见明显代谢增高脑区。结论 T2DM患者大脑静息葡萄糖代谢改变以区域性葡萄糖代谢减低为主，且基本呈双侧对称分布，主要涉及的脑区包括情感、认知功能区和视觉皮层区等。
Abstract:
Objective To invetigate the metabolic changes in the resting brain glucose of patients with type 2 diabetes but without brain metastasis. Methods A total of 96 patients with type 2 diabetes were confirmed by 18F-FDG PET/CT examination. The whole-body 18F-FDG PET/CT images of the patients were retrospectively analyzed. Ninety-six healthy subjects were included as controls for comparison. The metabolic changes in resting brain glucose of the 96 patients with type 2 diabetes were analyzed using a statistical parametric mapping software. Data were processed with two independent sample t test of voxel to voxel in the images. Results Compared with the control group, the hypometabolic brain areas in patients with type 2 diabetes were in the bilateral middle-inferior frontal, bilateral superior-heschl gyrus, bilateral superior-middle-lingual gyrus, calcarine cortex, bilateral inferior parietal gyrus, and bilateral wedge anterior lobe(t=5.51-6.42, all P<0.001). Hypermetabolic areas were not observed in patients. Conclusions The reduced metabolic cerebral regions in the patients with type 2 diabetes involved a number of functional regions related to visual cortex and mood disorders.

参考文献/References:

[1] Gu WJ, Wan YD, Tie HT, et al. Risk of acute lung injury/acute respiratory distress syndrome in critically Ⅲ adult patients with pre-existing diabetes:a meta-analysis[J/OL]. PLoS One, 2014, 9(2):e90426[2017-09-08]. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090426.DOI:10.1371/journal.pone.0090426.
[2] Kovacic JC, Castellano JM, Farkouh ME, et al. The relationships between cardiovascular disease and diabetes:focus on pathogenesis[J]. Endocrinol Metab Clin North Am, 2014, 43(1):41-57. DOI:10.1016/j.ecl.2013.09.007.
[3] Umamahesh K, Vigneswari A, Surya Thejaswi G, et al. Incidence of cardiovascular diseases and associated risk factors among subjects with type 2 diabetes-an 11-year follow up study[J]. Indian Heart J, 2014, 66(1):5-10. DOI:10.1016/j.ihj.2013.12.009.
[4] Reske-Nielsen E, Lundbaek K, Gregersen G, et al. Pathological changes in the central and peripheral nervous system of young long-term diabetics. The terminal neuro-muscular apparatus[J]. Diabetologia,1970, 6(2):98-103. DOI:10.1007/BF01257917.
[5] Xia W, Wang S, Sun Z, et al. Altered baseline brain activity in type 2 diabetes:a resting-state fMRI study[J]. Psychoneuroendocrinology, 2013, 38(11):2493-2501. DOI:10.1016/j.psyneuen.2013.05.012.
[6] Liu ZY, Cui XW, Tang ZC, et al. Identifying cognitive impairment in type 2 diabetes with functional connectivity:a multivariate pattern analysis of resting state fMRI data[J]. Proc SPIE, 2017, 10137:1-6. DOI:10.1117/12.2254062.
[7] Cui Y, Li SF, Gu H, et al. Disrupted brain connectivity patterns in patients with type 2 diabetes[J]. AJNR Am J Neuroradiol, 2016, 37(11):2115-2122. DOI:10.3174/ajnr.A4858.
[8] 齐颖, 张人玲. 糖尿病患者脑血流灌注及糖代谢的临床特点[J]. 中华糖尿病杂志, 2005, 13(4):272-273. DOI:10.3321/j.issn:1006-6187.2005.04.013. Qi Y, Zhang RL. Clinical characteristics of cerebral blood perfusion and metabolism of galactoside in type 2 diabetic patients[J]. Chin J Diabetes, 2005, 13(4):272-273.
[9] 林铮, 陈怀红, 徐磊, 等. 2型糖尿病合并轻度认知损害的正电子发射计算机断层扫描研究[J]. 中华精神科杂志, 2012, 45(2):89-92. DOI:10.3763/cma.j.issn.1006-7884.2012.02.008. Lin Z, Chen HH, Xu L, et al. Positron emission tomography imaging study of mild cognitive impairment in patients with 2 type diabetes mellitus[J]. Chin J Psychiatry, 2012, 45(2):89-92.
[10] Kawasaki K, Ishii K, Saito Y, et al. Influence of mild hyperglycemia on cerebral FDG distribution patterns calculated by statistical parametric mapping[J]. Ann Nucl Med, 2008, 22(3):191-200. DOI:10.1007/s12149-007-0099-7.
[11] 赵晋华, 赵佩琴, 赵燕, 等. 2型糖尿病患者局部脑血流灌注与认知功能障碍的关系[J]. 中华核医学杂志, 2001, 21(1):49-51. DOI:10.3760/cma.j.issn.2095-2848.2001.01.019. Zhao JH, Zhao PQ, Zhao Y, et al. Relationship between regional cerebral perfusion and cognitive disorders in type 2 diabetes mellitus[J]. Chin J Nucl Med, 2001, 21(1):49-51.
[12] Gold SM, Dziobek I, Sweat V, et al. Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes[J]. Diabetologia, 2007, 50(4):711-719. DOI:10.1007/s00125-007-0602-7.
[13] 姜东朗, 冯洪波, 邱湘哲, 等. 18F-FDG PET/CT评价糖尿病前期患者脑葡萄糖代谢的改变[J]. 中国医学影像技术, 2016, 32(8):1184-1188. DOI:10.13929/j.1003-3289.2016.08.009. Jiang DL, Feng HB, Qiu XZ, et al. 18F-FDG PET/CT in evaluation of glucose metabolism change in prediabetes patients’ brain[J]. Chin J Med Imaging Technol, 2016, 32(8):1184-1188.
[14] 邵辉丽, 杜小霞. 楔前叶/后扣带皮层在静息态功能网络中起关键节点作用的研究进展[J]. 磁共振成像, 2011, 2(3):215-217. DOI:10.3969/j.issn.1674-8034.2011.03.011. Shao HL, Du XX. Progress of the research on the role of key node of precuneus/posterior cingulated cortex in default brain functional network[J]. Chin J Magn Reson Imaging, 2(3):215-217.
[15] Liang M, Chen X, Xue F, et al. Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy[J]. Exp Ther Med, 2017, 14(2):1153-1156. DOI:10.3892/etm.2017.4582.
[16] Roy S, Kern TS, Song B, et al. Mechanistic insights into pathological changes in the diabetic retina:implications for targeting diabetic retinopathy[J]. Am J Pathol, 2017, 187(1):9-19. DOI:10.1016/j.ajpath.2016.08.022.
[17] Huang C, Wu M, Du J, et al. Systematic modeling for the insulin signaling network mediated by IRS(1) and IRS(2)[J]. J Theor Biol, 2014, 355(34):40-52. DOI:10.1016/j.jtbi.2014.03.030.
[18] Zhang D, Meng H, Yang HS. Antidiabetic activity of Taxus cuspidata polysaccharides in streptozotocin-induced diabetic mice[J]. Int J Biol Macromol, 2012, 50(3):720-724. DOI:10.1016/j.ijbiomac.2011. 12.020.
[19] De Nazareth AM. Type 2 diabetes mellitus in the pathophysiology of Alzheimer’s disease[J]. Dement Neuropsychol, 2017, 11(2):105-113. DOI:10.1590/1980-57642016dn11-020002.
[20] Li W, Wang T, Xiao S. Type 2 diabetes mellitus might be a risk factor for mild cognitive impairment progressing to Alzheimer’s disease[J]. Neuropsychiatr Dis Treat, 2016, 12:2489-2495. DOI:10.2147/NDT.S111298.

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备注/Memo

备注/Memo:
收稿日期:2017-09-08。
基金项目:河南省医学科技攻关计划省部共建项目（201701026）
通讯作者:徐俊玲,Email:xjlhzq@163.com
更新日期/Last Update: 2018-03-20