Objective:To evaluate the correlation between white matter hyperintensity (WMH) load and distribution characteristics with cognitive impairment in type 2 diabetic (T2DM) patients.Methods:Twenty T2DM patients with mild cognitive impairment (MCI), 20 T2DM patients without MCI and 20 age-matched non-diabetic controls were recruited from Tongji Hospital during the year 2013 and 2015. WMH was evaluated based on the visual scales of Fazekas (FS) and modified Scheltens (MSS), and the correlation between WMH load and cognitive function were analyzed by Spearman correlation analysis. After 5 years of follow-up, the changes in WMH load, WMH distribution features and cognitive function were compared between the healthy controls and T2DM patients. Analysis of variance rank sum test and chi square test were used for the comparison.Results:There was significant difference in FS and MSS scores among the three groups (F=8.600, 9.176, P < 0.01), and the scores of T2DM patients were significantly higher than those of healthy controls (P < 0.05 or < 0.01). The MSS scores of periventricular, frontal lobe, basal ganglia, temporal lobe and occipital lobe of the three groups were significantly different (F=12.069, 6.575, 8.358, 4.869, 6.037, P < 0.01). The MSS scores of T2DM patients were higher than those of healthy controls (P < 0.05 or < 0.01), and the MSS scores of basal ganglia, temporal lobe and occipital lobe in T2DM with MCI group were higher than those in T2DM without MCI group (P < 0.05). WMH load was negatively correlated with cognitive function (P < 0.05 or < 0.01). After 5 years following-up, the mini-mental state examination score decreased significantly in healthy controls (t=3.167, P < 0.01), the montreal cognitive assessment score decreased significantly in both healthy controls and T2DM patients (t=5.734, 3.863, P < 0.01), and the FS and MSS scores increased significantly in both healthy controls and T2DM patients (FS score: t=3.811, 4.564; MSS score: t = 4.839, 6.010; P < 0.01).Conclusion:Cognitive impairment in T2DM patients is related with WMH, and the load and distribution of WMH may be used as promising imaging biomarkers for the evaluation of cognitive impairment in T2DM patients.

2型糖尿病患者认知功能障碍与脑白质高信号负荷及分布特征的相关性