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患有阻塞性睡眠呼吸暂停的2型糖尿病患者的脑功能变化:多中心静止状态fMRI研究

Wang Zhezi¹, Huang Xiaoshan², Liu Yue¹

¹Department of Radiology Imaging Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, PR China.

|September 6, 2025

概括

2型糖尿病 (T2DM) 和阻塞性睡眠呼吸暂停 (OSA) 显著改变大脑功能,特别是在额头和网络. 这些变化与高血糖,低氧和认知能力下降有关,强调需要综合治疗.

科学领域:

神经成像
内分泌学
睡眠医学

背景情况:

2型糖尿病 (T2DM) 和阻塞性睡眠呼吸暂停 (OSA) 是常见的同时发生的疾病.
这两种T2DM和OSA都与认知障碍和神经并发症的风险增加有关.
了解这些共同和独特的神经机制是有效管理的关键.

研究的目的:

调查T2DM与OSA并发症患者的静止状态大脑功能变化.
了解患者群体中大脑功能障碍的潜在神经机制.
将观察到的脑部变化与临床和认知测量相关联.

主要方法:

一项多中心研究涉及139名参与者:48名健康对照组,46名T2DM患者和45名OSA患者.
使用休息状态功能磁共振成像 (rs-fMRI) 来评估大脑功能,使用度中心性 (DC),低频波动幅度 (ALFF) 和功能连接性 (FC).
统计分析包括与临床 (例如,禁食葡萄糖) 和神经心理 (例如,MoCA) 测量进行的群体比较和部分相关性分析.

主要成果:

在T2DM患者中,右副海马环中ALFF降低,与禁食葡萄糖相关.
患有OSA的T2DM患者在左侧中央上额头环中表现出较低的DC,在双侧中央上额头环和左侧中间额头环中表现出较低的ALFF.
在额头和网络中观察到改变的FC,与MoCA得分和氧气不和指数 (ODI) 相关.

结论:

在T2DM和与OSA共存的T2DM中存在广泛的脑功能异常,特别是影响额头和网络.
这些变化与高血糖,间歇性缺氧和认知障碍显著相关.
这些发现提供了基于成像的神经机制的见解,并强调了T2DM和OSA患者预防认知衰退的综合干预的重要性.

关键词:

大脑损伤认知障碍中心地位的程度功能连接性阻塞性睡眠呼吸暂停 2 型糖尿病

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