CAJ | 학술논문

目的探讨2型糖尿病(DM)患者与健康对照者认知功能水平与脑区体积的异同.方法应用多维度神经心理测试对比评估21例2型DM患者和19名健康对照者的神经认知功能;并采用基于体素的脑形态学(VBM)方法研究两组受试者全脑及局部脑区结构差异.结果 2型DM组听觉词语记忆测试-延迟回忆项(AVLT-delay recall)[(5.7±1.8)分]、听觉词语记忆测试-再认回忆项(AVLT-recognition)[(20.8±2.6)分]和画钟测试(CDT)[(8.0±1.1)分]成绩均显著差于对照组[分别为(7.3±1.4)分,(22.7±1.2)分,(9.5±2.5)分].2型DM组全脑灰质容积[(528±65)mm~3]明显小于对照组[(614±80)mm~3],在全脑容积(TIV)校正后差异仍有统计学意义.2型DM患者双侧颞上回,左侧颞中回,双侧岛叶,双侧额中回,右侧额下回,左侧顶下小叶,双侧中央前回,双侧扣带后回,左侧扣带前回,双侧海马旁回及右侧楔前叶体积较对照组明显萎缩(P<0.001).2型DM患者全脑灰质容积/TIV与体重指数(BMI)呈负相关,全脑灰质容积与糖化血红蛋白(HbA1c)负相关.AVLT-delay recall和AVLT-recognition与BMI和HbA1c均负相关,CDT与HbA1c呈负相关.结论 2型DM患者认知水平降低且伴全脑灰质容积减少及局部脑萎缩,提示2型DM患者可能存在加速脑老化的因素,引起认知功能下降.
목적 탐토2형당뇨병(DM)환자여건강대조자인지공능수평여뇌구체적적이동.방법 응용다유도신경심리측시대비평고21례2형DM환자화19명건강대조자적신경인지공능;병채용기우체소적뇌형태학(VBM)방법연구량조수시자전뇌급국부뇌구결구차이.결과 2형DM조은각사어기억측시-연지회억항(AVLT-delay recall)[(5.7±1.8)분]、은각사어기억측시-재인회억항(AVLT-recognition)[(20.8±2.6)분]화화종측시(CDT)[(8.0±1.1)분]성적균현저차우대조조[분별위(7.3±1.4)분,(22.7±1.2)분,(9.5±2.5)분].2형DM조전뇌회질용적[(528±65)mm~3]명현소우대조조[(614±80)mm~3],재전뇌용적(TIV)교정후차이잉유통계학의의.2형DM환자쌍측섭상회,좌측섭중회,쌍측도협,쌍측액중회,우측액하회,좌측정하소협,쌍측중앙전회,쌍측구대후회,좌측구대전회,쌍측해마방회급우측설전협체적교대조조명현위축(P<0.001).2형DM환자전뇌회질용적/TIV여체중지수(BMI)정부상관,전뇌회질용적여당화혈홍단백(HbA1c)부상관.AVLT-delay recall화AVLT-recognition여BMI화HbA1c균부상관,CDT여HbA1c정부상관.결론 2형DM환자인지수평강저차반전뇌회질용적감소급국부뇌위축,제시2형DM환자가능존재가속뇌노화적인소,인기인지공능하강.
Objective To investigate the differences of cognitive function and brain volume between patients with type 2 diabetes mellitus (DM) and healthy controls.Methods Multi-dimensional neuropsychological tests were employed to evaluated cognitive function in 21 type 2 DM patients and 19 healthy controls,and voxel-based morphometry method was applied to measure volum of whole and regional gray matter in brain of these subjects. Results Compared to healthy controls [(7. 3±1.4),(22.7±1.2),(9.5±2.5) respectively],significantly impaired performance of Auditory Verbal Learning Test (AVLT)-Delay Recall,[(5.7±1.8)]AVLT-Recognition [(20. 8±2. 6)]and Clock Drawing Test (CDT) [(8.0±1.1)]and extensive atrophy of gray matter (after corrected by total intracranial volume)were observed in type 2 DM patients (P<0.05). In addition,whole gray matter/Total Intracranial Volume (TIV) was significantly negatively correlated with BMI(r=-0.352,P=0.013). And negative correlations existed between whole gray matter vs HbA1c(r=-0.309,P=0.026); the performance of AVLT-Delay Recall and AVLT-Recognition vs BMI(r=-0.398,P=0.011;r=-0.4,P=0.011)and HbA1c (r=-0.354,P=0.025;r=-0.323,P=0.042) and CDT vs HbA1c (r=-0.322,P=0.043).Conclusion Mutli-cognitive impairment was associated with the reduced volume of whole and regional gray matter in brain of type 2 DM patients,which indicated that "accelerated brain ageing" might present in type 2 DM patients.