Hyperglycaemia is associated with changes in the regional concentrations of glucose and myo-inositol within the brain.
OBJECTIVE
The aim of the study was to assess the effect of hyperglycaemia on regional concentrations of glucose and other substrates within the brain in non-diabetic individuals and in patients with type 1 diabetes.


METHODS
The brain metabolites of 17 men with type 1 diabetes and 12 age-matched non-diabetic men (22-43 years old) were studied after an overnight fast (plasma glucose 9.2 +/- 3.0 vs 4.8 +/- 0.5 mmol/l, respectively). N-Acetylaspartate (NAA), creatine, choline, myo-inositol (mI) and glucose in the frontal cortex, frontal white matter and thalamus were quantified with proton magnetic resonance spectroscopy.


RESULTS
In the non-diabetic participants, the glucose level was 47% higher (p < 0.01) in the frontal cortex than in the frontal white matter. In contrast, this regional variation was not observed in the diabetic participants, in whom the glucose level in the frontal white matter was 64% higher (p < 0.001) and in the frontal cortex 25% higher (p = 0.033) than that of the non-diabetic participants. In the diabetic participants, the glucose level in each of the three regions studied correlated with fasting plasma glucose (r = 0.88-0.67, p < 0.01). In addition, in the diabetic participants, mI was 20% higher (p < 0.001) and NAA 6% lower (p = 0.037) in the frontal white matter, and mI was 8% higher (p = 0.042) in the frontal cortex, than in the non-diabetic participants.


CONCLUSIONS
In type 1 diabetes, hyperglycaemia is associated with accumulation of glucose and mI in the cortex and in the white matter.
Heikkilä
O
O
Folkhälsan Research Center, Folkhälsan Institute of Genetics, Biomedicum Helsinki (C330b), University of Helsinki, P.O. Box 63, 00014, Helsinki, Finland. outi.heikkila@helsinki.fi
Lundbom
N
N
Timonen
M
M
Groop
P-H
PH
Heikkinen
S
S
Mäkimattila
S
S
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001921:Brain / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000503:physiopathology; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism*; D007294:Inositol / Q000378:metabolism*; D008055:Lipids / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D018579:Patient Selection; D012016:Reference Values; D055815:Young Adult
D001786:Blood Glucose; D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D005947:Glucose; D006442:Glycated Hemoglobin; D007294:Inositol; D008055:Lipids