山西医科大学学报2026，Vol.57Issue(7)：814-823,10.DOI:10.13753/j.issn.1007-6611.2026.07.010
脑白质高信号在2型糖尿病患者脑灌注与认知功能中的中介作用
Mediating effect of white matter hyperintensity in cerebral perfusion and cognitive function of patients with type 2 diabetes mellitus
摘要
Abstract
Objective To explore the relationships between white matter hyperintensities(WMH),cerebral blood flow(CBF),and cognitive function in patients with type 2 diabetes mellitus(T2DM),and evaluate the mediating effect of WMH in the association between CBF and cognitive impairment.Methods Thirty-six T2DM patients and twenty-nine healthy controls undergoing conventional MRI and arterial spin labeling imaging were enrolled in this study.Clinical data and cognitive performance were collected.WMH volume,CBF and cognitive function were compared between T2DM group and control group.Correlation and multiple linear regression analyses were performed to explore the associations among CBF,WMH,and cognitive function.Furthermore,mediation analysis was conducted to explore the mediating role of WMH in the relationship between CBF and cognitive function.Results Compared with controls,T2DM patients had significantly lower MoCA scores and longer completion times on CTT-A and CTT-B(P<0.05).Compared with control group,CBF values in the bilateral insulae,right inferior frontal gyrus,and right inferior parietal lobule in the middle cerebral artery(MCA)territory significantly decreased in T2DM group(P<0.05),while total WMH volume,and WMH volume within anterior cerebral artery and MCA territories significantly increased(P<0.05).CTT-A completion time was positively correlated with MCA-WMH volume(r=0.418,P=0.011),and negatively correlated with MCA-CBF(r=-0.348,P=0.037).MCA-CBF was negatively correlated with MCA-WMH(r=-0.351,P=0.036).Multiple linear regression identified MCA-WMH as an independent predictor of CTT-A completion time(β=0.72,P<0.001).Mediation analysis results demonstrated that MCA-WMH fully mediated the relationship between MCA-CBF and CTT-A,with a 95%confidence interval for the indirect effect ranging from-0.56 to-0.05.Conclusion In T2DM patients,WMH burden is independently associated with executive dysfunction,and cerebral hypoperfusion may contribute to cognitive impairment by promoting white matter damage.关键词
2型糖尿病/脑血流灌注/脑白质高信号/认知功能/磁共振成像Key words
type 2 diabetes mellitus/cerebral blood perfusion/white matter hyperintensity/cognitive function/magnetic resonance imaging分类
医药卫生引用本文复制引用
李菁,潘佩纯,高冰倩,张小玲,高洁..脑白质高信号在2型糖尿病患者脑灌注与认知功能中的中介作用[J].山西医科大学学报,2026,57(7):814-823,10.基金项目
国家自然科学基金面上项目(82170820) （82170820）
