T2DM患者丘脑微观结构改变与轻度认知功能障碍及肠道短链脂肪酸的相关性  

The correlation between microstructural changes in the hypothalamus and mild cognitive impairment and short-chain fatty acids in the gut in T2DM patients

作　　者：许珊 汪旭洋 杨东 沈晶[1] 林琳[1] 伍建林[1] XU Shan;WANG Xuyang;YANG Dong;SHEN Jing;LIN Lin;WU Jianlin(Department of Radiology Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院放射科,大连116001

出　　处：《磁共振成像》2024年第1期76-81,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金面上项目(编号:82071911);大连市科技创新基金项目(编号:2021JJ12SN38)。

摘　　要：目的 利用扩散峰度成像(diffusion kurtosis imaging, DKI)评估2型糖尿病(type 2 diabetes mellitus, T2DM)患者背侧丘脑的微观结构改变,探讨DKI的参数变化与认知功能评分及肠道短链脂肪酸改变的相关性。材料与方法 对57例T2DM患者[其中T2DM伴轻度认知障碍(mild cognitive impairment,MCI)患者(T2DM-MCI组) 29例、 T2DM不伴MCI患者(T2DM-nonMCI组)28例]和30例健康对照(healthy control, HC)(HC组)双侧丘脑进行DKI数据采集,测量其各向异性分数(fractional anisotropy, FA)值、平均峰度(mean kurtosis, MK)值、径向峰度(radial kurtosis, RK)值及峰度分数各向异性(fractional anisotropy of kurtosis, FAK)值;同时行肠道代谢物短链脂肪酸检测;将3组间差异脑区的平均DKI参数值与认知功能评分及短链脂肪酸行相关性分析。结果 T2DM-MCI组左侧丘脑MK值均低于T2DM-nonMCI及HC组,且T2DM-MCI与T2DM-nonMCI组间差异具有统计学意义(P<0.05);与HC组比较,T2DM-MCI组左侧丘脑RK、右侧丘脑FA、KFA值均减低(P<0.05),两两比较显示左侧丘脑RK值在HC与T2DM-nonMCI组间差异有统计学意义(P<0.05),右侧丘脑FA、KFA值在T2DM-nonMCI与T2DM-MCI组间差异有统计学意义(P<0.05)。此外,T2DM患者右侧丘脑FA、FAK值与MoCA评分呈正相关(r=0.328,P=0.015;r=0.435,P=0.001);左侧丘脑RK值与己酸浓度呈正相关(r=0.431,P=0.001);左侧丘脑MK值与MoCA评分及己酸浓度呈正相关(r=0.294,P=0.030;r=0.287,P=0.033);右侧丘脑FAK值与TMT-A评分之间呈负相关(r=-0.318,P=0.018)。结论 T2DM患者丘脑微观结构改变可能是引起认知障碍的重要生理机制,且肠道己酸含量或可在一定程度上影响左侧丘脑微观结构完整性。Objective:To assess microstructural changes in the posterior thalamus of type 2 diabetes mellitus(T2DM)patients using diffusion kurtosis imaging(DKI)and investigate the correlation between DKI parameter changes,cognitive function scores,and alterations in short-chain fatty acids in the gut.Materials and Methods:DKI data were collected from both sides of the thalamus in 57 T2DM patients[comprising 29 T2DM-mild cognitive impairment(MCI)cases and 28 T2DM-nonMCI and 30 healthy controls(HC group)].Various DKI parameters including fractional anisotropy(FA),mean kurtosis(MK),radial kurtosis(RK),and fractional anisotropy of kurtosis(FAK)were measured.Additionally,short-chain fatty acid levels in the gut were assessed.Correlation analyses were performed between the average DKI parameter values in different brain regions among the three groups,cognitive function scores,and short-chain fatty acids.Results:The T2DM-MCI group exhibited significantly lower left thalamic MK values compared to both the T2DM-nonMCI and HC groups(P<0.05).In comparison to HC,the T2DM-MCI group showed a general decrease in left thalamic RK,right thalamic FA,and KFA values(P<0.05).Pairwise comparisons revealed statistically significant differences in left thalamic RK values between HC and T2DM-nonMCI groups(P<0.05),as well as in right thalamic FA and KFA values between T2DM-nonMCI and T2DM-MCI groups(P<0.05).Furthermore,in T2DM patients,there was a positive correlation between right thalamic FA and FAK values and MoCA scores(r=0.328,P=0.015;r=0.435,P=0.001).Left thalamic RK values were positively correlated with butyric acid(r=0.431,P=0.001).Left thalamic MK values exhibited positive correlations with MoCA scores and butyric acid(r=0.294,P=0.030;r=0.287,P=0.033).Right thalamic FAK values showed a negative correlation with TMT-A scores(r=-0.318,P=0.018).Conclusions:Microstructural changes in the thalamus of T2DM patients may be an important physiological mechanism underlying cognitive impairment,and gut butyric acid levels may partially influence the

关 键 词：2型糖尿病 扩散峰度成像 磁共振成像 肠道短链脂肪酸 认知功能障碍 

分 类 号：R445.2[医药卫生—影像医学与核医学] R781.64[医药卫生—诊断学] R749.24[医药卫生—临床医学] R591.3