AUTHOR=Lu Xuefang , Gong Wei , Wen Zhi , Hu Lanhua , Peng Zhoufeng , Zha Yunfei 

TITLE=Correlation Between Diabetic Cognitive Impairment and Diabetic Retinopathy in Patients With T2DM by 1H-MRS

JOURNAL=Frontiers in Neurology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.01068

DOI=10.3389/fneur.2019.01068

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> To explore the correlation between diabetic cognitive impairment (DCI) and diabetic retinopathy (DR) through examining the cognitive function and the metabolism of the cerebrum in Type 2 diabetes mellitus (T2DM) by <sup>1</sup>H-MRS.</p><p><bold>Methods:</bold> Fifty-three patients with T2DM were enrolled for this study. According to the fundus examination, the patients were divided into the DR group (<italic>n</italic> = 26) and the T2DM without DR group (T2DM group, <italic>n</italic> = 27). Thirty healthy adults were selected as a control group (HC group, <italic>n</italic> = 30). Cognitive function was measured by Montreal Cognitive Assessment (MoCA). The peak areas of N-acetylaspartate (NAA), Cho-line (Cho), Creatine (Cr), and Myo-inositol (mI) as well as their ratios were detected by proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS). The difference analysis between the three groups was performed by one-way ANOVA. When <italic>p</italic> &lt; 0.05, LSD-t was applied. A partial correlation analysis (with age as a covariate) was used to analyze the correlation between metabolites in the DR group and MoCA scores. Among all T2DM patients, Chi-square test age, gender, education level, BMI, SBP, DBP, FPG, HbA1c, TC, TG, HDL-C, LDL-C, DR, and DCI correlation were measured. Differences were statistically significant while <italic>P</italic> &lt; 0.05.</p><p><bold>Results:</bold> 1. The scores of MoCA in the DR group or in the T2DM group were significantly less than those in the HC group (<italic>F</italic> = 3.54, <italic>P</italic> &lt; 0.05), and the scores of MoCA in the DR group were significantly less than those in the other groups (<italic>F</italic> = 3.61, <italic>P</italic> &lt; 0.05). 2. There were significant differences for NAA in the bilateral hippocampus in DR patients, T2DM patients, and healthy controls (<italic>P</italic> &lt; 0.05). 3. The NAA/Cr was significantly positively correlated with the score of MoCA in DR patients' left hippocampus (<italic>r</italic> = 0.781, <italic>P</italic> &lt; 0.01). 4. Chi-square analysis found that there was a correlation between DR and DCI (<italic>x</italic><sup>2</sup> = 4.6, df = 1, <italic>p</italic> = 0.032, plt: 0.05). There was no correlation between other influencing factors and DCI (<italic>P</italic> &gt; 0.05).</p><p><bold>Conclusion:</bold> DCI is closely correlated with the DR in patients with T2DM. Hippocampal brain metabolism may have some changes in two sides of NAA in patients with DR, <sup>1</sup>H-MRS may provide effective imaging strategies and methods for the early diagnosis of brain damage and quantitative assessment cognitive function in T2DM.</p>