2型糖尿病共病抑郁患者静息态脑功能局部一致性  

Resting-state brain regional homogeneity in patients with type 2 diabetes mellitus comorbid depression

作　　者：柳瑞芳 黄刚[2] 田静 陆亚姗 郭茜[3] 赵莲萍[2] LIU Ruifang;HUANG Gang;TIAN Jing;LU Yashan;GUO Qian;ZHAO Lianping(The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Radiology,Gansu Provincial Hospital,Lanzhou 730000,China;Department of Endocrinology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院(甘肃省人民医院),甘肃兰州730000 [2]甘肃省人民医院放射科,甘肃兰州730000 [3]甘肃省人民医院内分泌科(干部病房3),甘肃兰州730000

出　　处：《中国医学影像技术》2022年第4期506-510,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81901724、81860306);甘肃省自然科学基金(20JR5RA156);甘肃省人民医院院内科研基金项目(19SYPYA-2);中国科学院2020年度“西部青年学者”项目资助;甘肃中医药大学2019级研究生创新基金。

摘　　要：目的采用静息态功能MRI(rs-fMRI)观察2型糖尿病(T2DM)共病抑郁(T2DD)患者静息态脑功能活动同步性异常改变及其与临床指标的相关性。方法纳入接受认知心理量表评估及头颅MRI检查的52例T2DD患者(T2DD组)、59例T2DM患者(T2DM组)及53名健康成人[健康对照(HC)组],记录其临床资料;计算组内静息态局部一致性(ReHo)值,记录组间ReHo差异显著脑区。以Pearson相关分析评价组间差异显著脑区的ReHo值与临床变量及认知心理量表评分结果的相关性。结果T2DD组低密度脂蛋白(LDL)低于T2DM组(P<0.05)。3组间简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)、汉密尔顿抑郁量表-24项(HAMD-24)及汉密尔顿焦虑量表(HAMA)评分差异均有统计学意义(P均<0.05);T2DD组MMSE和MoCA评分均低于HC组(P均<0.05);T2DD组HAMD-24、HAMA评分均高于T2DM组和HC组(P均<0.05)。静息态下,3组ReHo值较高脑区主要包括额中回、额上回和楔叶等,ReHo值较低脑区主要包括楔前叶、颞中回和前扣带回等。与HC组比较,T2DD组左侧前扣带回ReHo值明显减低(P<0.05)。T2DD组左侧前扣带回ReHo值与胰岛素抵抗指数(IRI)及LDL均呈负相关(r=-0.356、-0.312,P均<0.05),与认知心理量表及其他临床变量均无明显相关性(P均>0.05)。结论T2DD患者左侧前扣带回静息态局部脑功能同步性受损,且与IRI及LDL呈负相关。Objective To explore the changes of resting-state brain function activity synchronization in type 2 diabetes mellitus(T2DM)comorbid depression(T2DD)patients with resting-state MRI(rs-fMRI),and to observe the correlation with clinical indicators.Methods Data of 52 T2DD patients(T2DD group),59 T2DM patients(T2DM group)and 53 healthy adults(healthy controls[HC]group)who underwent evaluation of cognitive psychological scale and brain MRI were retrospectively analyzed,and the clinical indicators were recorded.The intra-group regional homogeneity(ReHo)values were calculated,and the then brain regions with significant different ReHo between groups were recorded.Pearson correlation analysis was conducted of ReHo values of significantly different brain regions,clinical variables and neuropsychological test scores.Results The low density lipoprotein(LDL)in T2DD group was lower than that in T2DM group(P<0.05).The scores of mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),Hamilton depression scale-24(HAMD-24)and Hamilton anxiety scale(HAMA)were significantly different among 3 groups(all P<0.05).The scores of MMSE and MoCA in T2DD group were lower than those in HC group(both P<0.05),of HAMD-24 and HAMA in T2DD group were higher than those in T2DM group and HC group(all P<0.05).Under resting-state,the regions with higher ReHo values in 3 groups mainly included the middle frontal gyrus,superior frontal gyrus,cuneus,etc.,while those with lower ReHo values mainly included the precuneus,middle temporal gyrus,anterior cingulate gyrus and so on.Compared with HC group,ReHo value of left anterior cingulate gyrus in T2DD group was significantly lower(P<0.05).In T2DD group,ReHo value of left anterior cingulate gyrus was negatively correlated with insulin resistance index(IRI)and LDL(r=-0.356,-0.312,both P<0.05),but not obviously correlated with cognitive psychological scale nor other clinical variables(all P>0.05).Conclusion In T2DD patients,regional brain function activity synchronization of resting-state left an

关 键 词：糖尿病 2型 抑郁症 磁共振成像 局部一致性 

分 类 号：R587.1[医药卫生—内分泌] R749.4[医药卫生—内科学]