1型糖尿病儿童白质微观结构的差异在长度随访期间持续存在:与低血糖症的关系
Nelly Mauras1, Qianheng Ma2, Stuart A Weinzimer3
1Division of Endocrinology, Diabetes & Metabolism, Nemours Children's Health, Jacksonville, FL.
Diabetes
|June 2, 2025
概括
患有1型糖尿病的儿童表现出持久的白质变化,特别是较低的轴向扩散率,在青春期减少. 过高血糖会对大脑发育产生负面影响,但良好的血糖控制可以保护白质的完整性.
科学领域:
- 神经科学是一个神经科学.
- 儿科内分泌学 儿科内分泌学
- 放射学 放射学是指放射学
背景情况:
- 已知1型糖尿病 (T1D) 对儿童的白质微观结构产生负面影响.
- 在T1D中,童年和青春期白质的纵向变化尚不清楚.
- 了解这些变化对于评估T1D对大脑发育的长期影响至关重要.
研究的目的:
- 与对照组相比,研究T1D儿童白质微观结构的纵向变化.
- 检查这些变化在成长和青春期如何演变.
- 评估血糖控制与白质完整性和神经认知结果之间的关联.
主要方法:
- 长度研究涉及143名患有T1D的儿童和71名对照,在基线时年龄为4-9岁.
- 大脑MRI与扩散张力成像 (DTI) 在6-8年内进行了四次.
- 使用混合效应建模分析的神经认知,血糖 (包括持续的葡萄糖监测) 和DTI指标 (FA,AD,RD,MD).
主要成果:
- 白质微观结构 (FA,AD,RD,MD) 在两组中随着年龄的增长而显著变化,但对于FA,RD和MD,随着时间的推移没有群体差异.
- 患有T1D的儿童在6-10岁时表现出较低的轴向扩散率 (AD),而不是对照组,这种差异在青春期 (12岁) 减少.
- 高血糖 (高血糖) 与较低的分数异构性 (FA) 和较高的辐射扩散率 (RD) 和平均扩散率 (MD) 相关. 更高的时间范围与更高的FA和更好的认知指标有关.
结论:
- 患有T1D的儿童的白质轴性扩散性下降,在青春期这种缺陷不那么明显.
- 分数异位性与高血糖相反,表明慢性高血糖会对白质完整性和髓化产生负面影响.
- 这些发现凸显了慢性高血糖症对T1D儿童发育中的大脑的持续有害影响.
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