伴微血管并发症的2型糖尿病患者脑动态功能连接研究  

Study of dynamic brain functional connectivity in type 2 diabetic patients with microvascular complications

作　　者：雷雨萌 官一童 张东升 LEI Yumeng;GUAN Yitong;ZHANG Dongsheng(Department of Imaging Diagnosis,Faculty of Medical Technology,Xi’an Medical University,Shaanxi 710021,China)

机构地区：[1]西安医学院医学技术学院影像诊断教研室,陕西西安710021 [2]陕西省人民医院MRI室,陕西西安710068

出　　处：《影像诊断与介入放射学》2025年第1期44-50,共7页Diagnostic Imaging & Interventional Radiology

基　　金：陕西省教育厅科学研究计划项目(23JK0647);西安市未央区科工局科技计划项目(202332);西安医学院“医臻基因育才计划”学生科研项目(2024YZ20);西安医学院第五批校级重点扶持学科(医学技术12202306)。

摘　　要：目的应用动态功能连接(dFNC)分析方法探究伴微血管并发症的2型糖尿病(T2DM-MC)患者脑网络功能连接的时变特征。方法采集44例T2DM-MC患者及人口学资料匹配的55名健康对照(HC)的静息态功能磁共振(rsfMRI)数据。通过独立成分分析(ICA)提取脑功能网络,采用滑动时间窗技术构建dFNC矩阵,应用K-means聚类分析将d FNC矩阵聚类为6个脑网络状态,并计算动态功能连接指标参数(时间分数、平均停留时间、转换次数)。最后,采用双样本t检验比较组间动态功能连接状态及特征参数的差异,并与神经心理学测试及临床资料行相关性分析。结果与HC组相比,T2DM-MC组在弱连接状态2(State 2)中,时间分数显著减低(P<0.05);状态1(State 1)中默认模式网络(DMN)与左侧额顶叶网络(LFPN)功能连接减低(FDR校正,P<0.05)。此外,T2DM-MC患者State 2时间分数与空腹血糖呈负相关(r=-0.431,P<0.05),State 1中DMN-LFPN功能连接与糖化血红蛋白水平呈负相关(r=-0.383,P<0.05)。结论T2DM-MC患者动态功能网络的改变主要发生在稀疏状态下,长期高糖状态或血糖控制不佳可能是导致T2DM-MC患者动态功能网络异常的重要因素。Objective To explore the temporal properties of brain functional connectivity in patients with microvascular complications from type 2 diabetes mellitus(T2DM-MC)using dynamic functional network connectivity(dFNC)analysis.Methods Resting state functional MRI(rs-fMRI)were performed on 44 patients with T2DM-MC and 55 healthy controls(HC)matched with demographic data.Brain functional networks were extracted by independent component analysis(ICA),dFNC matrix was constructed by sliding time window technology,k-means clustering analysis was used to cluster dFNC matrix into six brain network states.The dynamic functional connectivity parameters including fraction time,mean dwell time,and number of transitions were calculated.Two-sample t test was used to compare the dFNC states and characteristic parameters between the two groups.The correlation between the dynamic functional connectivity states,neuropsychological tests and clinical data was analyzed.Results Compared with the HC group,T2DM-MC group had a significantly reduced fraction time in weakly connected State 2(P<0.05).In State 1,the functional connectivity between default mode network(DMN)and left frontoparietal network(LFPN)was significantly decreased(FDR corrected,P<0.05).In T2DM-MC patients,the fraction time of State 2 was negatively correlated with fasting blood glucose(r=-0.431,P<0.05)and the functional connectivity of DMN-LFPN in State 1 was negatively correlated with glycosylated hemoglobin(r=-0.383,P<0.05).Conclusion The changes of dynamic functional network in T2DM-MC patients mainly occur in the sparse state.Long-term high glucose state or poor blood glucose control may be an important factor leading to abnormal dynamic functional network in T2DM-MC patients.

关 键 词：2型糖尿病 功能磁共振成像 动态功能连接 微血管并发症 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]