2型糖尿病患者大脑静息葡萄糖代谢改变研究

马藤; 轩昂; 张杰; 付畅; 孙萌萌; 尤阳; 徐俊玲

doi:10.3760/cma.j.issn.1673-4114.2018.01.005

2型糖尿病患者大脑静息葡萄糖代谢改变研究

Changes in resting-state brain glucose metabolism in patients with type 2 diabetes

摘要

摘要:
目的探讨静息状态下2型糖尿病（T2DM）患者大脑葡萄糖代谢改变特点。
方法回顾性分析96例已被临床确诊的T2DM患者的头部¹⁸F-FDG PET/CT显像资料。选取96名健康体检者作为对照组。采用统计参数地形图 8软件分析T2DM患者组与对照组PET脑代谢的改变。T2DM患者组与对照组图像采用体素对体素的两独立样本t检验。
结果与对照组比较，T2DM患者¹⁸F-FDG PET/CT表现为多个脑区的葡萄糖代谢减低（t=5.51~6.42，均P < 0.001），主要包括双侧额中下回、双侧颞上横回、双侧枕上中舌回、双侧楔前叶、双侧顶下缘角回、距状裂及周围皮层；未见明显代谢增高脑区。
结论T2DM患者大脑静息葡萄糖代谢改变以区域性葡萄糖代谢减低为主，且基本呈双侧对称分布，主要涉及的脑区包括情感、认知功能区和视觉皮层区等。

Abstract:
ObjectiveTo invetigate the metabolic changes in the resting brain glucose of patients with type 2 diabetes but without brain metastasis.
MethodsA total of 96 patients with type 2 diabetes were confirmed by ¹⁸F-FDG PET/CT examination. The whole-body ¹⁸F-FDG PET/CT images of the patients were retrospectively analyzed. Ninety-six healthy subjects were included as controls for comparison. The metabolic changes in resting brain glucose of the 96 patients with type 2 diabetes were analyzed using a statistical parametric mapping software. Data were processed with two independent sample t test of voxel to voxel in the images.
ResultsCompared with the control group, the hypometabolic brain areas in patients with type 2 diabetes were in the bilateral middle-inferior frontal, bilateral superior-heschl gyrus, bilateral superior-middle-lingual gyrus, calcarine cortex, bilateral inferior parietal gyrus, and bilateral wedge anterior lobe(t=5.51-6.42, all P < 0.001). Hypermetabolic areas were not observed in patients.
ConclusionsThe reduced metabolic cerebral regions in the patients with type 2 diabetes involved a number of functional regions related to visual cortex and mood disorders.

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