2型糖尿病患者丘脑损伤及其与认知功能及肠道菌群的相关性

Thalamic microstructural changes and correlations with cognitive function and gut microbiota in patients with type 2 diabetes mellitus

目的观察2型糖尿病(T2DM)患者丘脑微结构改变及其与认知功能及肠道菌群的相关性。方法前瞻性纳入63例T2DM患者和33名健康志愿者(HC组),根据蒙特利尔认知评估量表(MoCA)将T2DM患者分为伴轻度认知障碍(MCI)组(MCI组,n=32)和不伴MCI组(nonMCI组,n=31)。对各组采集颅脑平均表观传播子MRI(MAP-MRI),测量丘脑q-space逆方差(QIV)、均方位移(MSD)、返回原点概率(RTOP)、返回轴概率(RTAP)及返回平面概率(RTPP);行认知量表评估并检测肠道菌群;对比观察3组间MAP-MRI参数差异及其与认知量表评分及肠道菌群α、β多样性指数的相关性。结果3组右侧丘脑RTOP、RTAP及左侧丘脑RTPP差异均有统计学意义(P均<0.05);两两比较,MCI组与nonMCI组间差异亦有统计学意义(P均<0.05)。部分肠道菌群丰度及多样性指数3组间差异有统计学意义(P均<0.05)。T2DM患者右侧丘脑RTOP及RTPP均与MoCA评分呈正相关(r=0.332、0.284,P=0.010、0.028);左侧丘脑RTAP与Chao1及Unweighted_MDS2呈负相关(r=-0.255、-0.257,P=0.049、0.047),左侧丘脑RTOP与Unweighted_MDS2呈负相关(r=-0.279,P=0.031)。结论T2DM患者右侧丘脑RTOP、RTAP及左侧丘脑RTPP发生改变并与认知功能及肠道菌群多样性相关。

Objective To observe the thalamic microstructural changes and its correlation with cognitive function and gut microbiota in patients with type 2 diabetes mellitus(T2DM).Methods Sixty-three T2DM patients and 33 healthy volunteers(HC group)were prospectively enrolled,then T2DM patients were divided into with mild cognitive impairment group(MCI group,n=32)or without MCI group(nonMCI group,n=31)according to Montreal cognitive assessment(MoCA).Brain mean apparent propagator-MRI(MAP-MRI)were collected,q-space inverse variance(QIV),mean square displacement(MSD),return to the origin probability(RTOP),return to the axis probability(RTAP)and return to the plane probability(RTPP)of thalamus were measured.The cognitive scale was performed and gut microbiota was evaluated.MAP-MRI parameters were compared among 3 groups,and its correlation with cognitive scale scores and the α-diversity index and β-diversity index of gut microbiota were analyzed.Results There were significant differences of right thalamic RTOP,RTAP and left thalamic RTPP among 3 groups(all P<0.05),as well as between MCI group and nonMCI group(all P<0.05).There were significant differences of some diversity indexes and the abundance of some gut microbiota among 3 groups(all P<0.05).Right thalamic RTOP and RTAP of T2DM patients were positively correlated with MoCA scores(r=0.332,0.284;P=0.010,0.028),while left thalamic RTAP was negatively correlated with Chao1 and Unweighted_MDS2(r=-0.255,-0.257;P=0.049,0.047),and left thalamus RTOP was negatively correlated with unweighted_MDS2(r=-0.279,P=0.031).Conclusion Right thalamic RTOP,RTAP and left thalamic RTPP of T2DM patients changed,and were related to cognitive function and gut microbiota diversity.