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• Clinical Article •
Correlation between cortical atrophy and cognitive function in pre-diabetes and type 2 diabetes mellitus
LI Xin  ZHANG Wen  LIU Jiani  FU Linqing  MIAO Yingwen  ZHANG Xin  CHNE Jiu  BI Yan  ZHANG Bing 

Cite this article as: LI X, ZHANG W, LIU J N, et al. Correlation between cortical atrophy and cognitive function in pre-diabetes and type 2 diabetes mellitus[J]. Chin J Magn Reson Imaging, 2024, 15(4): 9-14, 19. DOI:10.12015/issn.1674-8034.2024.04.002.


[Abstract] Objective To explore the change pattern of cerebral cortex in pre-diabetes (PDM) and type 2 diabetes mellitus (T2DM) and its relationship with cognitive function, and explore the early image markers of abnormal blood glucose metabolism.Materials and Methods This study included 48 normal controls (NC), 30 PDM subjects and 96 T2DM patients. Cognitive function test, clinical biochemical examination and high-resolution 3D-T1WI magnetic resonance were performed. The morphological analysis based on voxel and surface was carried out using CAT12 software, and the cortical structural parameters such as the volume of brain gray matter, cortical thickness and sulcus depth were obtained, and the differences among the three groups were compared. The threshold of P<0.05 and FWE correction were used for multiple comparison and correction.Results Compared to NC, the gray matter volume of right frontal inferior orbital gyrus and left postcentral gyrus of PDM subjects decreased, and the brain gray matter atrophy in T2DM patients, especially the right superior temporal gyrus, right frontal inferior orbital gyrus, the right middle temporal gyrus and the left postcentral gyrus (P<0.05, FWE corrected). Thickness of right prefrontal cortex decreased in T2DM patients (P<0.05, FWE corrected). In the subjects with abnormal blood glucose metabolism, the whole brain gray matter volume is negatively correlated with HOMA-IR (r=-0.227, P=0.012, uncorrected) and Trail Making Test A (r=-0.250, P=0.001, FDR corrected), and positively correlated with the number span-backward (r=0.267, P=0.003, FDR corrected). Cortical thickness was negatively correlated with hemoglobin A1c (r=-0.181, P=0.040, uncorrected) and postprandial blood glucose at 2 hours (r=-0.272, P=0.020, uncorrected), and positively correlated with postprandial insulin (r=0.236, P=0.010, uncorrected) and HOMA 2-B (r=0.207, P=0.022, uncorrected).Conclusions In this study, it was found that there was gray matter atrophy in pre-diabetes and global gray matter atrophy in T2DM patients, which was related to attention and working memory function. Therefore, cortical atrophy may be an early imaging marker of diabetes-related brain injury. This suggests that prediabetes subjects should also strictly control blood sugar, and early intervention is beneficial to prevent cognitive impairment and improve prognosis.
[Keywords] type 2 diabetes mellitus；pre-diabetes mellitus；magnetic resonance imaging；cortical atrophy；cognitive function

LI Xin1   ZHANG Wen1   LIU Jiani1   FU Linqing1   MIAO Yingwen2   ZHANG Xin1   CHNE Jiu1   BI Yan2   ZHANG Bing1*  

1 Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China

2 Department of endocrinology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China

Corresponding author: ZHANG B, E-mail: zhangbing_nanjing@nju.edu.cn

Conflicts of interest   None.

Received  2023-09-25
Accepted  2024-03-04
DOI: 10.12015/issn.1674-8034.2024.04.002
Cite this article as: LI X, ZHANG W, LIU J N, et al. Correlation between cortical atrophy and cognitive function in pre-diabetes and type 2 diabetes mellitus[J]. Chin J Magn Reson Imaging, 2024, 15(4): 9-14, 19. DOI:10.12015/issn.1674-8034.2024.04.002.

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