Correlation between cerebral neurotransmitters levels by proton magnetic resonance spectroscopy and HbA1c in patients with type 2 diabetes

doi:10.4239/wjd.v15.i6.1263

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World Journal of Diabetes

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World J Diabetes. Jun 15, 2024; 15(6): 1263-1271
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1263

Table 1 Clinical characteristics of study participates by quartiles of hemoglobin A1c

Variables	HbA1c quartiles				P value
Variables	Q1 (< 7.875), n = 32	Q2 (7.875-9.050), n = 33	Q3 (9.050-11.200), n = 32	Q4 (≥ 11.200), n = 33	P value
Age (yr)	63.5 ± 13.3	60.9 ± 9.7	59.5 ± 16.1	60.2 ± 13.0	0.640
Sex (male/female)	18/14 (56.3/43.8)	16/17 (48.5/51.5)	20/12 (62.5/37.5)	21/12 (63.6/36.4)	0.582
Diabetes duration (yr)	6.5 (3.0, 17.5)	10 (6.5, 15.0)	8.0 (1.3, 19.8)	5.0 (1.0, 12.0)	0.173
Height (cm)	165.6 ± 8.1	164.2 ± 8.8	166.8 ± 9.0	167.4 ± 6.6	0.392
Weight (cm)	71.5 ± 11.5	70.9 ± 11.4	73.8 ± 18.3	71.4 ± 8.7	0.803
BMI (kg/m²)	26.1 ± 3.7	26.2 ± 3.3	26.2 ± 4.5	25.4 ± 2.5	0.772
Neck line (cm)	39.1 ± 3.5	38.2 ± 3.8	38.3 ± 4.0	38.4 ± 2.4	0.731
Waist line (cm)	97.3 ± 8.9	95.0 ± 10.2	94.5 ± 11.1	94.7 ± 8.5	0.646
Hip line (cm)	103.5 ± 8.3	102.1 ± 8.8	100.3 ± 9.7	100.9 ± 8.7	0.492
WHR	0.94 ± 0.05	0.93 ± 0.04	0.94 ± 0.05	0.94 ± 0.04	0.698
SBP (mmHg)	132.8 ± 21.2	139.1 ± 17.5	132.6 ± 20.3	134.3 ± 16.2	0.474
DBP (mmHg)	77.2 ± 9.0	80.0 ± 8.2	78.3 ± 9.0	80.3 ± 8.0	0.415
mALB (g/L)	11.0 (11.0, 41.5)	11.0 (10.5, 50.0)	32.5 (12.0, 123.5)	20.0 (12.5, 53.5)	0.031
TC (mmol/L)	4.46 ± 1.01	4.70 ± 1.11	4.81 ± 1.29	5.00 ± 1.35	0.321
TG (mmol/L)	1.54 (1.04, 2.32)	2.17 (1.10, 2.93)	1.81 (1.37, 3.83)	1.37 (0.84, 2.28)	0.044
HDL-C (mmol/L)	1.25 ± 0.37	1.11 ± 0.32	1.10 ± 0.31	1.14 ± 0.31	0.274
LDL-C (mmol/L)	2.83 ± 1.10	3.02 ± 1.02	2.89 ± 0.88	3.51 ± 1.15	0.037
HOMA-IR	3.09 (1.69, 4.48)	4.59 (3.07, 7.12)	6.05 (4.34, 10.41)	6.06 (3.62, 8.14)	< 0.001
HOMA-β	80.15 (35.79, 131.06)	38.55 (21.90, 73.18)	53.04 (22.48, 96.73)	21.70 (10.86, 45.92)	0.001
Complicated with hypertension (%)	17 (53.1)	21 (63.6)	17 (53.1)	18 (54.5)	0.796
Complicated with CHD (%)	20 (62.5)	18 (54.5)	23 (71.9)	18 (54.5)	0.429

HbA1c: Hemoglobin A1c; BMI: Body mass index; WHR: Waist-to-hip ratio; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; mALB: Microalbumin; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; HOMA-IR: Homeostasis model assessment of insulin resistance; HOMA-β: Homeostasis model assessment of beta cell function; CHD: Coronary heart disease.

Table 2 Neurotransmitter levels of participates by quartiles of hemoglobin A1c

Neurotransmitters	HbA1c quartiles				P value
Neurotransmitters	Q1 (< 7.875), n = 32	Q2 (7.875-9.050), n = 33	Q3 (9.050-11.200), n = 32	Q4 (≥ 11.200), n = 33	P value
NAA/Cr (left hippocampus)	1.43 (0.55, 2.58)	0.74 (0.36, 1.72)	1.02 (0.80, 1.99)	1.60 (0.78, 3.10)	0.082
Cho/Cr (left hippocampus)	0.75 (0.42, 1.32)	0.96 (0.51, 1.63)	1.10 (0.29, 2.28)	1.36 (0.68, 2.27)	0.277
NAA/Cho (left hippocampus)	1.27 (0.62, 4.48)	1.02 (0.42, 1.61)	0.83 (0.44, 2.88)	0.95 (0.47, 1.81)	0.529
NAA/Cr (left brainstem area)	0.84 (0.33, 1.58)	1.17 (0.63, 2.11)	0.92 (0.30, 1.94)	1.72 (1.04, 3.48)	0.024
Cho/Cr (left brainstem area)	1.13 (0.62, 2.04)	1.55 (0.76, 3.44)	1.54 (1.28, 2.82)	1.74 (0.70, 2.49)	0.299
NAA/Cho (left brainstem area)	0.91 (0.32, 1.64)	0.71 (0.47, 1.06)	0.69 (0.31, 1.11)	1.41 (0.82, 2.05)	0.013

HbA1c: Hemoglobin A1c; NAA: N-acetylaspartate; Cr: Creatine; Cho: Choline.

Table 3 Correlation between variables and hemoglobin A1c by Spearman correlation analysis

Variables	r	P value
Age (yr)	-0.063	0.474
Sex (male/female)	-0.082	0.351
Diabetes duration (yr)	-0.150	0.090
Height (cm)	0.113	0.201
Weight (cm)	0.057	0.518
BMI (kg/m²)	-0.046	0.605
Neck line (cm)	-0.087	0.327
Waist line (cm)	-0.091	0.303
Hip line (cm)	-0.135	0.126
WHR	0.011	0.897
SBP (mmHg)	0.028	0.753
DBP (mmHg)	0.093	0.294
mALB (g/L)	0.215	0.014
TC (mmol/L)	0.154	0.081
TG (mmol/L)	-0.036	0.686
HDL-C (mmol/L)	-0.096	0.275
LDL-C (mmol/L)	0.216	0.014
HOMA-IR	0.345	< 0.001
HOMA-β	-0.316	< 0.001
Complicated with hypertension (%)	-0.015	0.868
Complicated with CHD (%)	-0.016	0.860
NAA/Cr (left hippocampus)	0.090	0.310
Cho/Cr (left hippocampus)	0.168	0.056
NAA/Cho (left hippocampus)	-0.061	0.502
NAA/Cr (left brainstem area)	0.257	0.007
Cho/Cr (left brainstem area)	0.128	0.182
NAA/Cho (left brainstem area)	0.166	0.081

BMI: Body mass index; WHR: Waist-to-hip ratio; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; mALB: Microalbumin; TC: Total cholesterol; TG: Triglyceride; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; HOMA-IR: Homeostasis model assessment of insulin resistance; HOMA-β: Homeostasis model assessment of beta cell function; CHD: Coronary heart disease; NAA: N-acetylaspartate; Cho: Choline; Cr: Creatine.

Table 4 Independent factors related to hemoglobin A1c by ordinal logistic regression analysis

Factors	OR (95%CI)	P value
mALB (g/L)	1.000 (0.999-1.001)	0.896
LDL-C (mmol/L)	1.627 (1.119-2.370)	0.011
HOMA-IR	1.107 (1.031-1.188)	0.005
HOMA-β	1.000 (1.000-1.001)	0.675
NAA/Cr (left hippocampus)	0.998 (0.971-1.025)	0.907
Cho/Cr (left hippocampus)	0.997 (0.882-1.127)	0.963
NAA/Cho (left hippocampus)	0.907 (0.795-1.035)	0.145
NAA/Cr (left brainstem area)	1.006 (0.894-1.133)	0.915
Cho/Cr (left brainstem area)	1.000 (0.901-1.108)	0.997
NAA/Cho (left brainstem area)	1.608 (1.004-2.578)	0.048

95%CI: 95% confidence interval; OR: Odds ratio; mALB: Microalbumin; LDL-C: Low-density lipoprotein cholesterol; HOMA-IR: Homeostasis model assessment of insulin resistance; HOMA-β: Homeostasis model assessment of beta cell function; NAA: N-acetylaspartate; Cho: Choline; Cr: Creatine.

Citation: Gao XY, Zhou CX, Li HM, Cheng M, Chen D, Li ZY, Feng B, Song J. Correlation between cerebral neurotransmitters levels by proton magnetic resonance spectroscopy and HbA1c in patients with type 2 diabetes. World J Diabetes 2024; 15(6): 1263-1271
URL: https://www.wjgnet.com/1948-9358/full/v15/i6/1263.htm
DOI: https://dx.doi.org/10.4239/wjd.v15.i6.1263