Когнитивные нарушения при сахарном диабете 1 типа
https://doi.org/10.18699/SSMJ20230101
Аннотация
Сахарный диабет (СД) 1 типа, одно из распространенных эндокринологических заболеваний детского возраста, имеет большое количество хронических микро- и макрососудистых осложнений, которые снижают продолжительность жизни детей и увеличивают затраты здравоохранения. Поражение ЦНС на фоне СД 1 типа у детей и подростков является достаточно распространенным, но плохо изученным осложнением. Ведущую роль в нарушении ЦНС занимает когнитивная дисфункция (КД). Патофизиологические аспекты КД при СД 1 типа остаются до конца не выясненными. В качестве трех основных триггеров выделяют гипогликемию, хроническую умеренную гипергликемию и острую гипергликемию (диабетический кетоацидоз). Приводятся доказательства нарушения в морфологии головного мозга у детей с СД 1 типа по ходу развития заболевания. Отмечены повреждения при формировании белого и серого вещества, гиппокампа, миндалины, описаны процессы нарушения миелинизации, что также может служить причиной развития КД у данного контингента больных. Описаны особенности клинических проявлений КД у детей и подростков с СД 1 типа в зависимости от локализации поражения головного мозга. При дебюте СД в период младшего детства (до 5 лет) отмечается более выраженная КД. Своевременная диагностика и коррекция КД на фоне СД 1 типа у детей и подростков может улучшить терапевтические и профилактические прогнозы при данном заболевании.
Об авторах
Ю. В. Быков
Ставропольский государственный медицинский университет Минздрава России; Детская городская клиническая больница им. Г.К. Филиппского
Россия
Россия
Юрий Витальевич Быков, к.м.н.
355017, г. Ставрополь, ул. Мира, 310
355002, г. Ставрополь, ул. Пономарева, 5
В. А. Батурин
Ставропольский государственный медицинский университет Минздрава России
Россия
Россия
Владимир Александрович Батурин, д.м.н.
355017, г. Ставрополь, ул. Мира, 310
Список литературы
1. Liu J., Fan W., Jia Y., Su X., Wu W., Long X., Sun X., Liu J., Sun W., Zhang T., … Wang J. Altered gray matter volume in patients with type 1 diabetes mellitus. Front. Endocrinol. (Lausanne). 2020;11:45. doi: 10.3389/fendo.2020.00045
2. Pignalosa F.C., Desiderio A., Mirra P., Nigro C., Perruolo G., Ulianich L., Formisano P., Beguinot F., Miele C., Napoli R., Fiory F. Diabetes and cognitive impairment: a role for glucotoxicity and dopaminergic dysfunction. Int. J. Mol. Sci. 2021;22(22):12366. doi: 10.3390/ijms222212366
3. Chen H.J., Lee Y.J., Huang C.C., Lin Y.F., Li S.T. Serum brain-derived neurotrophic factor and neurocognitive function in children with type 1 diabetes. J. Formos. Med. Assoc. 2021;120(1 Pt 1):157–164. doi: 10.1016/j.jfma.2020.04.011
4. He J., Li S., Liu F., Zheng H., Yan X., Xie Y., Li X., Zhou Z., Zhu X. Glycemic control is related to cognitive dysfunction in Chinese children with type 1 diabetes mellitus. J. Diabetes. 2018;10(12):948–957. doi: 10.1111/1753-0407.12775
5. Kanikarla-Marie P., Jain S.K. Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes. Free Radic. Biol. Med. 2016;95:268–277. doi: 10.1016/j.freeradbiomed.2016.03.020
6. Green A., Hede S.M., Patterson C.C., Wild S.H., Imperatore G., Roglic G., Beran D. Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults. Diabetologia. 2021;64(12):2741–2750. doi: 10.1007/s00125-021-05571-8
7. Rasmussen V.F., Jensen T.S., Tankisi H., Karlsson P., Vestergaard E.T., Kristensen K., Nyengaard J.R., Terkelsen A.J. Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review. J. Diabetes Complications. 2021;35(11):108027. doi: 10.1016/j.jdiacomp.2021.108027
8. Stanescu D.E., Lord K., Lipman T.H. The epidemiology of type 1 diabetes in children. Endocrinol. Metab. Clin. North Am. 2012;41:679–694. doi: 10.1016/j.ecl.2012.08.001
9. Powers A.C. Type 1 diabetes mellitus: much progress, many opportunities. J. Clin. Invest. 2021;131(8):e142242. doi: 10.1172/JCI142242
10. Seaquist E.R. The impact of diabetes on cerebral structure and function. Psychosom. Med. 2015;77(6):616–621. doi: 10.1097/ PSY.0000000000000207
11. Silva R.A.E., Ganen A.P., Fernandes V.F.T., Evangelista N.M.A., Figueiredo C.C., Pacheco L.A., Colares Neto G.P. Evaluation of sleep characteristics of children and adolescents with type 1 diabetes mellitus. Rev. Paul. Pediatr. 2021;40:e2020407. doi: 10.1590/1984-0462/2022/40/2020407
12. Zilliox L.A., Chadrasekaran K., Kwan J.Y., Russell J.W. Diabetes and cognitive impairment. Curr. Diab. Rep. 2016;16(9):87. doi: 10.1007/s11892-016-0775-x
13. Toprak H., Yetis H., Alkan A., Filiz M., Kurtcan S., Aralasmak A., Aksu M.Ş., Cesur Y. Relationships of DTI findings with neurocognitive dysfunction in children with type 1 diabetes mellitus. Br. J. Radiol. 2016;89(1059):20150680. doi: 10.1259/bjr.20150680
14. Dimeglio L.A., Evans-Molina C., Oram R.A. Type 1 diabetes. Lancet. 2018;391:2449–2462. doi: 10.1016/s0140-6736(18)31320-5
15. White N.H. Long-term outcomes in youths with diabetes mellitus. Pediatr. Clin. North. Am. 2015;62(4):889–909. doi: 10.1016/j.pcl.2015.04.004
16. Bjornstad P., Donaghue K.C., Maahs D.M. Macrovascular disease and risk factors in youth with type 1 diabetes: time to be more attentive to treatment? Lancet Diabetes Endocrinol. 2018;6(10):809–820. doi: 10.1016/S2213-8587(18)30035-4
17. Jin C.Y., Yu S.W., Yin J.T., Yuan X.Y., Wang X.G. Corresponding risk factors between cognitive impairment and type 1 diabetes mellitus:A narrative review. Heliyon. 2022; 8(8):e10073. doi: 10.1016/j.heliyon.2022.e10073
18. Wolf V., Abdul Y., Ergul A. Novel targets and interventions for cognitive complications of diabetes. Front. Physiol. 2022;12:815758. doi: 10.3389/fphys.2021.815758
19. Lyoo I.K., Yoon S., Renshaw P.F., Hwang J., Bae S., Musen G., Kim J.E., Bolo N., Jeong H.S., Simonson D.C., … Jacobson A.M. Network-level structural abnormalities of cerebral cortex in type 1 diabetes mellitus. PLoS One. 2013;8(8):e71304. doi: 10.1371/journal.pone.0071304
20. Schwartz D.D., Wasserman R., Powell P.W., Axelrad M.E. Neurocognitive outcomes in pediatric diabetes: a developmental perspective. Curr. Diab. Rep. 2014;14(10):533. doi: 10.1007/s11892-014-0533-x
21. Siller A.F., Lugar H., Rutlin J., Koller J.M., Semenkovich K., White N.H., Arbelaez A.M., Shimony J., Hershey T. Severity of clinical presentation in youth with type 1 diabetes is associated with differences in brain structure. Pediatr. Diabetes. 2017;18(8):686–695. doi: 10.1111/pedi.12420
22. van Sloten T.T., Sedaghat S., Carnethon M.R., Launer L.J., Stehouwer C.D. A. Cerebral microvascular complications of type 2 diabetes: stroke, cognitive dysfunction, and depression. Lancet Diab. Endocrinol. 2020; 8: 325–336. doi: 10.1016/S2213-8587(19)30405-X
23. Liu H., Yu S., Xu W., Xu J. Enhancement of 26S proteasome functionality connects oxidative stress and vascular endothelial inflammatory response in diabetes mellitus. Arter. Thromb. Vasc. Biol. 2012;32:2131–2140. doi: 10.1161/ATVBAHA.112.253385
24. Ahmad R., Chowdhury K., Kumar S., Irfan M., Reddy G.S., Akter F., Jahan D., Haque M. Diabetes mellitus: a path to amnesia, personality, and behavior change. Biology (Basel). 2022;11(3):382. doi: 10.3390/biology11030382
25. Lin L., Wu Y., Chen Z., Huang L., Wang L., Liu L. Severe hypoglycemia contributing to cognitive dysfunction in diabetic mice is associated with pericyte and blood-brain barrier dysfunction. Front. Aging Neurosci. 2021;13:775244. doi: 10.3389/fnagi.2021.775244
26. Embury C.M., Wiesman A.I., Proskovec A.L., Heinrichs-Graham E., McDermott T.J., Lord G.H., Brau K.L., Drincic A.T., Desouza C.V., Wilson T.W. Altered brain dynamics in patients with type 1 diabetes during working memory processing. Diabetes. 2018;67(6):1140–1148. doi: 10.2337/db17-1382
27. Cameron F.J., Northam E.A., Ryan C.M. The effect of type 1 diabetes on the developing brain. Lancet Child Adolesc. Health. 2019;3(6):427–436. doi: 10.1016/S2352-4642(19)30055-0
28. Tonoli C., Heyman E., Roelands B., Pattyn N., Buyse L., Piacentini M.F., Berthoin S., Meeusen R. Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature. J. Diabetes. 2014;6(6):499–513. doi: 10.1111/1753-0407.12193
29. Cameron F.J. The impact of diabetes on brain function in childhood and adolescence. Pediatr. Clin. North. Am. 2015;62(4):911–927. doi: 10.1016/j.pcl.2015.04.003
30. Shalimova A., Graff B., Gąsecki D., Wolf J., Sabisz A., Szurowska E., Jodzio K., Narkiewicz K. Cognitive dysfunction in type 1 diabetes mellitus. J. Clin. Endocrinol. Metab. 2019;104:2239–2249. doi: 10.1210/jc.2018-01315
31. Luna R., Manjunatha T.R., Bollu B., Jhaveri S., Avanthika C., Reddy N., Saha T., Gandhi F. A comprehensive review of neuronal changes in diabetics. Cureus. 2021;13(10):e19142. doi: 10.7759/cureus.19142
32. Roh E., Song D.K., Kim M.S. Emerging role of the brain in the homeostatic regulation of energy and glucose metabolism. Exp. Mol. Med. 2016;48(3):e216. doi: 10.1038/emm.2016.4
33. Jaser S.S., Jordan L.C. Brain health in children with type 1 diabetes: risk and protective factors. Curr. Diab. Rep. 2021;21(4):12. doi: 10.1007/s11892-021-01380-w
34. Janez A., Guja C., Mitrakou A., Lalic N., Tankova T., Czupryniak L., Tabák A.G., Prazny M., Martinka E., Smircic-Duvnjak L. Insulin therapy in adults with type 1 diabetes mellitus: a narrative review. Diabetes Ther. 2020;11:387–409. doi: 10.1007/s13300-019-00743-7
35. Ryan C.M. Long-term effects of hypoglycaemia on cognitive function in diabetes. In: Hypoglycaemia in Clinical Diabetes. Eds. B.M. Frier, S.R. Heller, R.J. McCrimmon. Chichester: Wiley-Blackwellley, 2014. P. 285–304.
36. Jackson D. A., Michael T., Vieira de Abreu A., Agrawal R., Bortolato M., Fisher S.J. Prevention of severe hypoglycemia-induced brain damage and cognitive impairment with verapamil. Diabetes. 2018;67:2107–2112. doi: 10.2337/db18-0008
37. Aberdeen H., Battles K., Taylor A., Garner-Donald J., Davis-Wilson A., Rogers B.T., Cavalier C., Williams E.D. The aging vasculature: glucose tolerance, hypoglycemia and the role of the serum response factor. J. Cardiovasc. Dev. Dis. 2021;8:58. doi: 10.3390/jcdd8050058
38. Blasetti A., Chiuri R.M., Tocco A.M., Giulio C.D., Mattei P.A., Ballone E., Chiarelli F., Verrotti A. The effect of recurrent severe hypoglycemia on cognitive performance in children with type 1 diabetes:a meta-analysis. J. Child. Neurol. 2011;26(11):1383–1391. doi: 10.1177/0883073811406730
39. Koepsell H. Glucose transporters in brain in health and disease. Pflugers Arc. 2020;472:1299–1343. doi: 10.1007/s00424-020-02441-x64
40. Rehni A.K., Dave K.R. Impact of hypoglycemia on brain metabolism during diabetes. Mol. Neurobiol. 2018;55:9075–9088. doi: 10.1007/s12035-018-1044-6
41. Ryan C.M., van Duinkerken E., Rosano C. Neurocognitive consequences of diabetes. Am. Psychol. 2016;71(7):563–576. doi: 10.1037/a0040455
42. Luo X., Wu J., Jing S., Yan L.J. Hyperglycemic stress and carbon stress in diabetic glucotoxicity. Aging Dis. 2016;7(1):90–110. doi: 10.14336/AD.2015.0702
43. Sergi D., Renaud J., Simola N., Martinoli M.G. Diabetes, a contemporary risk for parkinson’s disease: epidemiological and cellular evidences. Front. Aging Neurosci. 2019;11:302. doi: 10.3389/fnagi.2019.00302
44. Filip P., Canna A., Moheet A., Bednarik P., Grohn H., Li X., Kumar A.F., Olawsky E., Eberly L.E., Seaquist E.R., Mangia S. Structural alterations in deep brain structures in type 1 diabetes. Diabetes. 2020;69(11):2458–2466. doi: 10.2337/db19-1100
45. Cato M.A., Mauras N., Ambrosino J., Bondurant A., Conrad A.L., Kollman C., Cheng P., Beck R.W., Ruedy K.J., Aye T., … Diabetes Research in Children Network (DirecNet). Cognitive functioning in young children with type 1 diabetes. J. Int. Neuropsychol. Soc. 2014;20(2):238–247. doi: 10.1017/S1355617713001434
46. Li W., Huang E., Gao S.J. Type 1 diabetes mellitus and cognitive impairments: a systematic review. J. Alzheimers Dis. 2017;57:29–36. doi: 10.3233/JAD-161250
47. Tomkins M., McCormack R., O’Connell K., Agha A., Merwick A. Metabolic encephalopathy secondary to diabetic ketoacidosis: a case report. BMC Endocr. Disord. 2019;19:71. doi: 10.1186/s12902-019-0398-8
48. Jessup A.B., Grimley M.B., Meyer E., Passmore G.P., Belger A., Hoffman W.H., Çalıkoğlu A.S. Effects of diabetic ketoacidosis on visual and verbal neurocognitive function in young patients presenting with new-onset type 1 diabetes. J. Clin. Res. Pediatr. Endocrinol. 2015;7(3):203–210. doi: 10.4274/jcrpe.2158
49. Ghetti S., Kuppermann N., Rewers A., Myers S.R., Schunk S.E., Stoner M.J., Garro A., Quayle K.S., Brown K.M., Trainor J.L., … Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group. Cognitive function following diabetic ketoacidosis in children with new-onset or previously diagnosed type 1 diabetes. Diabetes Care. 2020;43:2768–2775. doi: 10.2337/dc20-0187
50. McCrimmon R.J., Ryan C.M., Frier B.M. Diabetes and cognitive dysfunction. Lancet. 2012; 379: 2291–2299. doi: 10.1016/S0140-6736(12)60360-2
51. Nunley K.A., Rosano C., Ryan C.M., Jennings J.R., Aizenstein H.J., Zgibor J.C., Costacou T., Boudreau R.M., Miller R., Orchard T.J., Saxton J.A. Clinically relevant cognitive impairment in middleaged adults with childhood-onset type 1 diabetes. Diabetes Care. 2015; 38: 1768–1776. doi: 10.2337/dc15-0041
52. Musen G., Tinsley L.J., Marcinkowski K.A., Pober D., Sun J.K., Khatri M., Huynh R., Lu A., King G.L., Keenan H.A. Cognitive function deficits associated with long-duration type 1 diabetes and vascular complications. Diabetes Care. 2018; 41: 1749–1756. doi: 10.2337/dc17-1955
53. Barnea-Goraly N., Raman M., Mazaika P., Marzelli M., Hershey T., Weinzimer S.A., Aye T., Buckingham B., Mauras N., White N.H., … Reiss A.L. Diabetes Research in Children Network (DirecNet). Alterations in white matter structure in young children with type 1 diabetes. Diabetes Care. 2014;37(2):332–340. doi: 10.2337/dc13-1388
54. Mauras N., Mazaika P., Buckingham B., Weinzimer S., White N.H., Tsalikian E., Hershey T., Cato A., Cheng P., Kollman C., … Diabetes Research in Children Network (DirecNet). Longitudinal assessment of neuroanatomical and cognitive differences in young children with type 1 diabetes: association with hyperglycemia. Diabetes. 2015; 64: 1770–1779. doi: 10.2337/db14-1445
55. Arbelaez A.M., Semenkovich K., Hershey T. Glycemic extremes in youth with T1DM: the structural and functional integrity of the developing brain. Pediatr. Diabetes. 2013;14(8):541–553. doi: 10.1111/pedi.12088
56. Aye T., Reiss A.L., Kesler S., Hoang S., Drobny J., Park Y., Schleifer K., Baumgartner H., Wilson D.M., Buckingham B.A. The feasibility of detecting neuropsychologic and neuroanatomic effects of type 1 diabetes in young children. Diabetes Care. 2011;34:1458–1462. doi: 10.2337/dc10-2164
57. He J., Ryder A.G., Li S., Liu W., Zhu X. Glycemic extremes are related to cognitive dysfunction in children with type 1 diabetes: A meta-analysis. J. Diabetes Investig. 2018(а);9(6):1342–1353. doi: 10.1111/jdi.12840
58. Duke D.C., Harris M.A. Executive function, adherence, and glycemic control in adolescents with type 1 diabetes: a literature review. Curr. Diab. Rep. 2014;14(10):532. doi: 10.1007/s11892-014-0532-y
59. Lin A., Northam E.A., Werther G.A., Cameron F.J. Risk factors for decline in IQ in youth with type 1 diabetes over the 12 years from diagnosis/illness onset. Diabetes Care. 2015;38(2):236–242. doi: 10.2337/dc14-1385
60. Stanisławska-Kubiak M., Mojs E., Wójciak R.W., Piasecki B., Matecka M., Sokalski J., Kopczyński P., Fichna P. An analysis of cognitive functioning of children and youth with type 1 diabetes (T1DM) in the context of glycemic control. Eur. Rev. Med. Pharmacol. Sci. 2018;22(11):3453–3460. doi: 10.26355/eurrev_201806_15170
61. Zou W., He J., Liu Y., Zhu J., Liu F., Xie Y., Li C., Du H., Huang F., Zhou Z., Li X., Zhu X. Sustained attention deficits in adults with juvenile-onset type 1 diabetes mellitus. Psychosom. Med. 2021;83(8):906–912. doi: 10.1097/PSY.0000000000000992
62. Limbers C.A., Emery K., Young D., Stephen M. Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes. J. Pediatr. Endocrinol. Metab. 2015;28(3-4):353–355. doi: 10.1515/jpem-2014-0317
Рецензия
Для цитирования:
Быков Ю.В., Батурин В.А. Когнитивные нарушения при сахарном диабете 1 типа. Сибирский научный медицинский журнал. 2023;43(1):4-12. https://doi.org/10.18699/SSMJ20230101
For citation:
Bykov Yu.V., Baturin V.A. Cognitive impairments in type 1 diabetes mellitus. Сибирский научный медицинский журнал. 2023;43(1):4-12. (In Russ.) https://doi.org/10.18699/SSMJ20230101
Просмотров:
1634
Послать статью по эл. почте 