Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2025; 16(7): 103468
Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.103468
Detect the disrupted brain structural connectivity in type 2 diabetes mellitus patients without cognitive impairment
Yi-Fan Li, Yue Wei, Ming-Rui Li, Zhi-Zhong Sun, Wei-Yan Xie, Qian-Fan Li, Chen-Hui Xie, Jing-Yi Xiang, Xin Tan, Shi-Jun Qiu, Yi Liang
Yi-Fan Li, Zhi-Zhong Sun, Chen-Hui Xie, Xin Tan, Shi-Jun Qiu, Yi Liang, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Yue Wei, Department of Basic Psychology, School of Psychology, HKUST-Shenzhen Research Institute, Shenzhen 518060, Guangdong Province, China
Yue Wei, Department of Basic Psychology, School of Psychology, Shenzhen University, Shenzhen 518060, Guangdong Province, China
Ming-Rui Li, Department of Magnetic Resonance Imaging, Zhanjiang First Hospital of Traditional Chinese Medicine, Zhanjiang 524000, Guangdong Province, China
Wei-Yan Xie, Department of Computer Science and Engineering, School of Engineering, The Hong Kong University of Science and Technology, Hong Kong 999077, China
Qian-Fan Li, Jing-Yi Xiang, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Co-first authors: Yi-Fan Li and Yue Wei.
Co-corresponding authors: Shi-Jun Qiu and Yi Liang.
Author contributions: Li YF and Wei Y contribute equally to this study as co-first authors; Li YF was responsible for conceptualization, validation, writing - original draft; Wei Y was responsible for methodology, software, formal analysis; Li MR, Sun ZZ and Li QF were responsible for investigation, visualization; Xie WY was responsible for software, formal analysis, visualization; Xie CH was responsible for investigation; Xiang JY was responsible for investigation; Tan X was responsible for resources, data curation; Qiu SJ was responsible for resources, data curation, supervision, funding acquisition; Liang Y was responsible for resources, data curation, writing - review & editing, supervision, funding acquisition.
Supported by National Natural Science Foundation of China, No. 82104698, No. 82330058, No. T2341014, and No. 32200923.
Institutional review board statement: All procedures were performed in compliance with relevant laws and institutional guidelines and have been approved by the Medical Research Ethics Committee of Guangzhou University of Chinese Medicine. The approval date is December 20, 2023, and the approval number is No. K-2023-146. The privacy rights of human subjects have been observed and that informed consent was obtained for experimentation with human subjects.
Informed consent statement: All participants provided written informed consent prior to enrollment. The study purpose, procedures, potential risks, and benefits were thoroughly explained to all participants.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this study.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data supporting this study are not publicly available due to ethical restrictions. Access may be granted upon reasonable request to the corresponding author after signing a data use agreement.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Liang, MD, PhD, Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Compound No. 16, Airport Road, Guangzhou 510405, Guangdong Province, China. lysogood@126.com
Received: November 21, 2024
Revised: March 21, 2025
Accepted: June 3, 2025
Published online: July 15, 2025
Processing time: 237 Days and 15.9 Hours
Core Tip

Core Tip: This study sheds light on the early-stage cognitive decline in type 2 diabetes mellitus (T2DM) by identifying disrupted brain connectivity and developing a classification model with a promising accuracy of 92.5%. Deep subcortical nuclei showed increased connectivity with the frontal lobe in T2DM patients without cognitive impairment. The diabetic brain exhibited measurable characteristics before patients presented with detectable cognitive impairments. The high-accuracy models demonstrate the potential of diffusion tensor imaging-based biomarkers for detecting preclinical cognitive decline and monitoring disease progression.