维生素D不足的老年糖尿病患者胼胝体的MRI影像改变与其认知功能的关系研究  

The relationship between MRI changes of corpus callosum and cognitive function in elderly diabetic patients with vitamin D deficiency

作　　者：董俊杰[1] 张玲[1] 马丽[2] Dong Junjie;Zhang Ling;Ma Li(Ward I,Cadre Health Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院干部保健中心一病区,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院干部保健中心门诊,乌鲁木齐830001

出　　处：《脑与神经疾病杂志》2024年第6期350-354,共5页Journal of Brain and Nervous Diseases

基　　金：新疆维吾尔自治区自然科学基金项目(2020D01C111)。

摘　　要：目的 研究维生素D摄入不足的老年2型糖尿病(T2DM)患者胼胝体的磁共振(MRI)影像改变与其认知功能的关系。方法 选择新疆维吾尔自治区人民医院干部保健中心一病区收治的127例维生素D摄入不足的老年T2DM患者为研究对象,均进行胼胝体MRI检查,并采用蒙特利尔认知评估量表(MoCA)评估其认知功能,根据MoCA评分结果将患者分为认知功能正常组与认知障碍组,对比两组胼胝体的MRI影像表现,探讨患者胼胝体的MRI影像改变与其认知功能的关系。结果 127例维生素D不足的老年T2DM患者中,MoCA评分≥26分者89例(认知功能正常组),MoCA评分<26分者38例(认知功能障碍组)。认知功能障碍组空腹血糖(FBG)、糖化血红蛋白(HbAlc)水平均高于认知功能正常组(P<0.05),维生素D水平低于认知功能正常组(P <0.05)。认知功能障碍组胼胝体压部与胼胝体膝部N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、NAA/肌酸(Cr)、Cho/Cr均低于认知功能正常组(P<0.05),Cr与认知功能正常组比较差异无统计学意义(P> 0.05)。认知功能障碍组胼胝体压部与胼胝体膝部FA值均低于认知功能正常组(P<0.05),表现砚散系数(ADC)值均高于认知功能正常组(P<0.05)。Pearson相关性分析显示,认知功能障碍组胼胝体压部NAA、NAA/Cr与患者MoCA评分均呈正相关(P<0.05),胼胝体膝部NAA、Cho、NAA/Cr、Cho/Cr与患者MoCA评分均表现为正相关性(P<0.05)。认知功能障碍组胼胝体压部、胼胝体膝部FA值与患者MoCA评分均表现为正相关性(P<0.05),胼胝体压部、胼胝体膝部ADC值与患者MoCA评分均呈负相关(P <0.05)。结论 维生素D摄入不足的老年T2DM患者MRI影像改变与其认知功能存在明显相关性,1H-MRS和DTI参数有利于评估维生素D不足的老年T2DM患者认知功能损害情况。Objective To study the relationship between magnetic resonance imaging(MRI)image changes of corpus callosum and cognitive function in elderly patients with type 2 diabetes(T2DM)with insufficient vitamin intake.Methods 127 elderly T2DM patients with insufficient vitamin D intake admitted to the First Ward of Cadre Health Care Center of the People's Hospital of Xinjiang were selected as the study subjects.All of them were examined with MRI of the Corpus callosum,and their cognitive function was assessed with the Montreal Cognitive Assessment(MoCA),According to the MoCA score,the patients were divided into the normal cognitive function group and the cognitive impairment group.The MRI findings of the corpus callosum in the two groups were compared,and the relationship between the MRI image changes of the Corpus callosum and their cognitive function was discussed.Results Among the 127 elderly T2DM patients with vitamin D deficiency,89 cases(normal cognitive function group)had MoCA score≥26,and 38 cases(cognitive dysfunction group)had MoCA score<26.The levels of fasting blood-glucose(FBG)and glycated hemoglobin(HbAlc)in the cognitive dysfunction group were higher than those in the cognitive normal group(P<0.05),and the level of vitamin D was lower than that in the cognitive normal group(P<0.05).The levels of N-acetylaspartic acid(NAA),choline(Cho),NAA/creatine(Cr),Cho/Cr in the pressure of the corpus callosum and the knee of the corpus callosum in the cognitive dysfunction group were lower than those in the cognitive normal group(P<0.05),and there was no significant difference between Cr and the cognitive normal group(P>0.05).The FA values of corpus callosum pressure and corpus callosum knee in the cognitive dysfunction group were lower than those in the normal cognitive function group(P<0.05),and the ADC values were higher than those in the normal cognitive function group(P<0.05).Pearson correlation analysis showed that NAA and NAA/Cr of corpus callosum were positively correlated with MoCA score of patients in cogni

关 键 词：2型糖尿病 老年 维生素D摄入不足 胼胝体MRI 认知功能 

分 类 号：R743.32[医药卫生—神经病学与精神病学]