Impact of Fat Distribution and Metabolic Diseases on Cerebral Microcirculation: A Multimodal Study on Type 2 Diabetic and Obese Patients.
Regina EszeLászló BalkaySándor BarnaLilla Szatmáriné EgeresiMiklós EmriDénes PállGyörgy ParaghLiliána RajnaiSándor SomodiZita KepesIldikó GaraiMiklós KáplárPublished in: Journal of clinical medicine (2024)
Background : Since metabolic diseases and atherosclerotic vascular events are firmly associated, herein we investigate changes in central microcirculation and atherosclerosis-related body fat distribution in patients with type 2 diabetes mellitus and obesity. Methods: Resting brain perfusion single-photon emission computed tomography (SPECT) imaging with Technetium-99m hexamethylpropylene amine oxime ([ 99m Tc]Tc-HMPAO SPECT) was performed, and the breath-holding index (BHI) and carotid intima-media thickness (cIMT) were measured to characterise central microcirculation. Besides CT-based abdominal fat tissue segmentation, C-peptide level, glycaemic and anthropometric parameters were registered to search for correlations with cerebral blood flow and vasoreactivity. Results : Although no significant difference was found between the resting cerebral perfusion of the two patient cohorts, a greater blood flow increase was experienced in the obese after the breath-holding test than in the diabetics ( p < 0.05). A significant positive correlation was encountered between resting and provocation-triggered brain perfusion and C-peptide levels ( p < 0.005). BMI and cIMT were negatively correlated (rho = -0.27 and -0.23 for maximum and mean cIMT, respectively), while BMI and BHI showed a positive association (rho = 0.31 and rho = 0.29 for maximum and mean BHI, respectively), which could be explained by BMI-dependent changes in fat tissue distribution. cIMT demonstrated a disproportional relationship with increasing age, and higher cIMT values were observed for the men. Conclusions: Overall, C-peptide levels and circulatory parameters seem to be strong applicants to predict brain microvascular alterations and related cognitive decline in such patient populations.
Keyphrases
- obese patients
- cognitive decline
- contrast enhanced
- cerebral blood flow
- adipose tissue
- computed tomography
- blood flow
- type diabetes
- heart rate
- cerebral ischemia
- body mass index
- resting state
- white matter
- bariatric surgery
- weight gain
- weight loss
- heart rate variability
- metabolic syndrome
- subarachnoid hemorrhage
- mild cognitive impairment
- magnetic resonance imaging
- functional connectivity
- case report
- protein kinase
- positron emission tomography
- fatty acid
- roux en y gastric bypass
- pet ct
- cardiovascular disease
- body composition
- dual energy
- image quality
- deep learning
- magnetic resonance
- multiple sclerosis
- convolutional neural network
- machine learning
- optical coherence tomography
- pain management
- cardiovascular risk factors
- chronic pain
- middle aged
- drug induced
- photodynamic therapy