| Background and Objective:Type 2 diabetes mellitus(T2DM)has become an important risk factor for Alzheimer’s disease and can exacerbate Alzheimer’s disease in patients with mild cognitive impairment.Resting-state functional magnetic resonance imaging studies have shown that multiple neurological deficits and associated abnormal neural network connections occur in patients with type 2 diabetes.Changing living habits or strengthening physical activity can improve the brain function of patients and reduce the risk of Alzheimer’s disease in patients with type 2 diabetes.This study included obese patients with type 2 diabetes mellitus and explored the neural mechanisms of lifestyle interventions on cognitive and brain function in diabetic patients.Methods:Twenty obese patients with type 2 diabetes mellitus were collected,including 12 males and 8 females,aged 32-64 years and mean age 46.70±10.65 years.In addition,dietary interventions and exercise interventions were included in the subjects.The intervention time was 3 months.Clinical data,neuropsychological test data,and magnetic resonance resting state brain function data were collected before and after the intervention.Clinical data includes body weight,body mass index(BMI),waist circumference,blood pressure,fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglycerides,low-density lipoprotein,high-density lipoprotein.Neuropsychological scale tests include the Hamilton Depression Scale(HAMD),the Hamilton Grading Scale(HAMA),the Montreal cognitive assessment(MoCA),and the auditory language learning test(AVLT),complex figure test(CFT)delay memory.Magnetic resonance data acquisition using a 3.0T magnetic resonance scanner,including T2 weighted imaging(T2WI),fluid attenuation inversion recovery(FLAIR),3D T1 weighted imaging(3D-T1WI)and Functional Magnetic Resonance Imaging(fMRI).SPSS 22 software was used to perform two-sample paired t-tests on clinical data before and after lifestyle interventions and neuropsychological test data.p<0.05 was considered statistically significant.Using the DPABI software based on Matlab platform to perform statistical analysis on the smoothed brain functional images by two-sample paired t test,voxel-level p<0.01,cluster p<0.05 was considered abnormal brain regions.The DPABI software was used to extract regions of the brain with significant changes in ReHo values before and after the dietary treatment of the subjects as ROIs.The change of ReHo in each region of interest(ROI)was correlated with the clinical indicators of the subjects.The Spearman correlation analysis was performed on SPSS on the change of cognitive function scores.p<0.05 was considered statistically significant.Results:Twenty subjects were finally included in the study.Body weight,waist circumference,fasting blood glucose,HbA1 c,and triglyceride levels were significantly different(p<0.05)before and after lifestyle intervention.Blood pressure,total cholesterol,and low-density lipoprotein were measured before and after the intervention.There was no statistically significant difference in high density lipoprotein(p>0.05).There was no significant difference in the scores of HAMD,HAMA,MoCA,AVLT and CFT in the neuropsychological scale(p>0.05).The ReHo value of the occipital lobe of diabetic patients after lifestyle intervention was significantly higher than before intervention.The increase of ReHo value in the brain region included left calcarine,right calcarine,left lingual,right lingual and right cuneus.The increase in the degree of increase in ReHo values in the left calcarine of diabetic patients after lifestyle intervention was significantly associated with the degree of weight loss.The correlation coefficient was r=-0.461,p=0.041.Conclusion:In summary,the weight,waist circumference,fasting blood glucose,HbA1 c,and triglyceride levels in type 2 diabetes patients after lifestyle intervention were all significantly reduced,the patients had good blood glucose control and provided important reference for the early treatment of diabetic patients.The resting state brain function was enhanced,suggesting that lifestyle intervention may have a positive effect on the cognitive function of type 2 diabetic patients. |
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