胰岛素抵抗与2型糖尿病患者脑功能的相关性研究

摘要

目的 探讨2型糖尿病(T2DM)患者脑功能变化与胰岛素抵抗指数(HOMA-IR)的相关性.方法选取2015年8月—2016年9月就诊于陆军总医院内分泌科的T2DM患者31例为T2DM组;选择同时期体检非T2DM者28例为对照组.测量身高、体质量、血压,计算体质指数(BMI).检测空腹胰岛素(FINS)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)水平,计算HOMA-IR.采用3.0 T磁共振扫描仪监测并收集受试者自发大脑活动变化数据,运用低频振荡幅度法对数据进行处理.采用Pearson相关性分析HOMA-IR与相应脑区低频振荡幅度(ALFF)值的相关性.结果两组性别、年龄、BMI、收缩压、舒张压比较,差异均无统计学意义(P>0.05);T2DM组HbA1c高于对照组(P<0.05).T2DM组ALFF值小于对照组的有左后扣带回、小脑、左侧颞中回、右侧颞极颞上回、左侧三角部额下回、左侧额中回、左侧颞上回、左顶下小叶;T2DM组ALFF值大于对照组的有左侧海马旁回、右额上内侧回.Pearson相关性分析结果显示,HOMA-IR与小脑、右侧颞中回ALFF值呈负相关(r=-0.362,P=0.047;r=-0.383,P=0.038).结论胰岛素抵抗对T2DM患者脑功能活动产生影响,可能与抑郁有关.%Objective To investigate the relationship between spontaneous brain activity changes and HOMA-IR in patients with type 2 diabetes mellitus (T2DM). Methods From August 2015 to September 2016,31 T2DM patients treated in Department of Endocrinology,Army General Hospital were selected as T2DM group. At the same time,28 non-T2DM physical examination cases were selected as control group. Body height,body mass and blood pressure were measured,and body mass index (BMI)was calculated. The levels of fasting insulin (FINS),fasting blood glucose (FPG)and glycosylated hemoglobin (HbA 1c )were measured and the HOMA-IR was calculated. 3. 0 T magnetic resonance scanner was used to monitor and collect the data of spontaneous brain activity changes,and the low frequency oscillation amplitude (ALFF)was used to process the data. Pearson correlation analysis was conducted to investigate the correlation between HOMA-IR and ALFF values in the corresponding brain regions. Results There were no significant differences in gender,age,BMI,systolic blood pressure and diastolic blood pressure between the two groups (P > 0. 05). HbA 1c in T2DM group was higher than that in control group (P < 0. 05). The ALFF values in T2DM group were smaller than those in the control group,including left posterior cingulate gyrus,cerebellum, left middle temporal gyrus,right temporal superior temporal gyrus,left triangle,inferior frontal gyrus,left frontal gyrus,left superior temporal gyrus,and left inferior parietal lobule. The ALFF values in T2DM group were higher than those in the control group,including the left parahippocampal gyrus and the right superior frontal gyrus. Pearson correlation analysis showed that HOMA-IR was negatively correlated with ALFF value in cerebellum and right middle temporal gyrus (r =-0. 362,P = 0. 047;r=-0. 383,P = 0. 038). Conclusion Insulin resistance has an effect on brain function in T2DM and may be associated with depression.