摘要
目的基于表面形态学测量(SBM)探究2型糖尿病(T2DM)合并高血压患者的脑结构变化及与认知受损的相关性。方法选取2022年6月至2023年10月收治的40例T2DM患者为T2DM组,另选取40例T2DM合并高血压患者纳入T2DM合并高血压组。比较两组临床资料、基于SBM脑皮层厚度、蒙特利尔认知评估量表(MoCA)评分差异;Pearson相关分析基于SBM脑皮层厚度与认知评分的相关性,并分析基于SBM脑皮层厚度对T2DM合并高血压患者认知功能障碍的预测作用。结果T2DM合并高血压组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)均高于T2DM组,双侧全脑、旁中央回、中央后回、楔前叶、颞下回、颞中回皮层厚度均低于T2DM组,MoCA总分、延迟记忆、语言、视空间/执行功能、抽象思维、注意力评分及认知功能障碍发生率均低于T2DM组(P<0.05)。双侧全脑、旁中央回、中央后回、楔前叶、颞下回、颞中回皮层厚度与MoCA总分、延迟记忆、注意力、抽象思维、视空间/执行功能、语言评分均呈正相关(P<0.05)。基于SBM脑皮层厚度各指标联合预测的曲线下面积为0.929(95%CI:0.801,0.986)。结论T2DM合并高血压患者基于SBM脑皮层厚度明显降低,与认知受损显著相关,且对患者认知功能障碍有一定预测价值。
Objective To explore the changes of brain structure and its correlation with cognitive impairment in patients with type 2 diabetes mellitus(T2DM)and hypertension based on surface-based morphometry(SBM).Methods Forty patients with T2DM admitted from June 2022 to October 2023 were selected as the T2DM group,and another 40 patients with T2DM complicated with hypertension were included in the T2DM complicated with hypertension group.The clinical data,SBM-based cortical thickness and Montreal Cognitive Assessment(MoCA)scores were compared between the two groups.Pearson correlation analysis was used to examine the correlation between SBM-based cortical thickness and cognitive scores,and the predictive effect of SBM-based cortical thickness on cognitive dysfunction in patients with T2DM complicated with hypertension was analyzed.Results The fasting plasma glucose(FPG),2-hour postprandial glucose(2 hPG),and Hemoglobin A1c(HbA1c)levels in the T2DM complicated with hypertension group were all higher than those in the T2DM group.The cortical thicknesses of bilateral whole brain,paracentral gyrus,posterior central gyrus,precuneus,inferior temporal gyrus,and middle temporal gyrus in the T2DM complicated with hypertension group were all lower than those in the T2DM group,and the total MoCA score,delayed memory,language,visuospatial/executive function,abstract thinking,attention scores,and incidence of cognitive dysfunction were all lower than those in the T2DM group(P<0.05).The cortical thicknesses of bilateral whole brain,paracentral gyrus,posterior central gyrus,precuneus,inferior temporal gyrus,and middle temporal gyrus were positively correlated with the total MoCA score,delayed memory,attention,abstract thinking,visuospatial/executive function,and language scores(P<0.05).The area under the curve of combined detection of various indicators based on SBM cortical thickness for the prediction was 0.929(95%CI:0.801,0.986).Conclusion Patients with T2DM and hypertension exhibit a significant reduction in SBM-based cortical thickness,which is significantly correlated with cognitive impairment and has certain predictive value for patients'cognitive dysfunction.
作者
安明慧
徐倩
任瑞锋
AN Minghui;XU Qian;REN Ruifeng(Department of Nuclear Medicine,General Hospital of North China Petroleum Administration Bureau,Renqiu,Hebei 062552,China;Department of Medical Imaging,General Hospital of North China Petroleum Administration Bureau,Renqiu,Hebei 062552,China)
出处
《临床误诊误治》
2025年第16期36-41,共6页
Clinical Misdiagnosis & Mistherapy
基金
河北省2023年度医学科学研究课题(20231283)。
关键词
2型糖尿病
表面形态学测量
脑皮层厚度
高血压
认知功能
type 2 diabetes mellitus
surface-based morphometry
cortical thickness
hypertension
cognitive function
