关键词:

2型糖尿病, MRI, 皮质厚度, 偏侧性, 糖化血红蛋白

Abstract:

Objective　To establish a map of cerebral cortex thickness in patients with type 2 diabetes mellitus (T2DM) without consciousness disorder by brain magnetic resonance imaging and image analysis software, to analyze its distribution rule, and to explore the correlation between cerebral cortex thickness and glycated hemoglobin (HbA1c) in patients with T2DM. Methods　It was a retrospective study. From December 2020 to June 2021, 29 patients with T2DM without consciousness disorder who were diagnosed in Shouguang People's Hospital were included, including 18 males and 11 females, aged (60.43±1.47) years. High resolution three-dimensional T1 images were obtained from the 29 T2DM patients. Freesurfer software with automatic recognition and extraction system was used to calculate the thickness of each gyrus cortex based on the region of interest (ROI) of the gyrus. The obtained cortical thickness data were statistically analyzed, and the average cortical thickness of the brain region was mapped to the brain template to form a brain atlas. Pearson correlation analysis was conducted between the cortical structure data obtained and HbA1c by statistical analysis software. Paired t test was used to analyze the laterality of left and right hemispherical cortical thickness. Results　The brain regions with thicker cortex were temporal pole, entorhinal cortex, head of anterior cingulate gyrus, insula, frontal pole, middle temporal gyrus, and inferior temporal gyrus. The brain regions with thinner cortex were paracalcaneal gyrus, cuneiform lobe, lingual gyrus, posterior central gyrus, transverse temporal gyrus, lateral occipital gyrus, and superior parietal gyrus. The cortical thickness of the left and right cerebral hemispheres in T2DM patients was laterally distributed in the straight gyrus [(2.371±0.352) mm vs. (2.432±0.393) mm], lateral occipital gyrus [(2.141±0.185) mm vs. (2.201±0.221) mm], middle temporal gyrus [(2.662±0.364) mm vs. (2.724±0.353) mm], head of anterior cingulate gyrus [(2.665±0.453) mm vs. (2.791±0.506) mm], and frontal pole [(2.749±0.398) mm vs. (2.616±0.422) mm] (t=-2.613, -3.161, -3.106, -2.317, and 2.771; P=0.014, 0.004, 0.004, 0.028, and 0.010). Laterality: except the thickness of frontal polar cortex to the left, the rest of brain regions were to the right. The cortical thicknesses of left cuneiform lobe, left paracentral gyrus, left anterior central gyrus, left superior parietal gyrus, left superior marginal gyrus, left frontal pole, left transverse temporal gyrus, right cuneiform lobe, right anterior central gyrus, right anterior cuneiform lobe, right superior parietal gyrus, and right transverse temporal gyrus were significantly negatively correlated with HbA1c (r=-0.608, -0.563, -0.546, -0.535, -0.488, -0.524, -0.487, -0.554, -0.552, -0.479, -0.522, and -0.475; all P<0.01). Conclusions　In this study, we found the distribution rule and laterality of cerebral cortex thickness in patients with T2DM without consciousness disorder, which provided the image structure basis for later brain science research. There was a correlation between cerebral cortex thickness and HbA1c in patients with T2DM.

Key words:

Type 2 diabetes mellitus, MRI, Cortical thickness, Laterality, Glycosylated hemoglobin