title: Assessment of changes in brain metabolites in Indian patients with type-2 diabetes mellitus using proton magnetic resonance spectroscopy.
abstract: BACKGROUND
  The brain is a target for diabetic end-organ damage, though the pathophysiology of diabetic encephalopathy is still not well understood. The aim of the present study was to investigate the effect of diabetes on the metabolic profile of brain of patients having diabetes in comparison to healthy controls, using in-vivo magnetic resonance spectroscopy to get an insight into the pathophysiology of cerebral damages caused due to diabetes.
  
  
  METHODS
  Single voxel proton magnetic resonance spectroscopy (1H-MRS) was performed at 1.5 T on right frontal, right parieto-temporal and right parieto-occipital white matter regions of the brain of 10 patients having type-2 diabetes along with 7 healthy controls. Absolute concentration of N-acetylaspartate (NAA), choline (cho), myo-inositol (mI), glutamate (Glu) and glutamine (Gln), creatine (Cr) and glucose were determined using the LC-Model and compared between the two groups.
  
  
  RESULTS
  The concentration of N-acetylaspartate was significantly lower in the right frontal [4.35 ±0.69 vs. 5.23 ±0.74; p = 0.03] and right parieto-occipital region [5.44 ±0.52 vs.6.08 ±0.25; p = 0.02] of the brain of diabetics as compared to the control group. The concentrations of glutamate and glutamine were found to be significantly higher in the right frontal region of the brain [7.98 ±2.57 vs. 5.32 ±1.43; P = 0.01] in diabetics. Glucose levels were found significantly elevated in all the three regions of the brain in diabetics as compared to the control group. However, no significant changes in levels of choline, myo-inositol and creatine were observed in the three regions of the brain examined among the two groups.
  
  
  CONCLUSIONS
  1H-MRS analysis indicates that type-2 diabetes mellitus may cause subtle changes in the metabolic profile of the brain. Decreased concentrations of NAA might be indicative of decreased neuronal viability in diabetics while elevated concentrations of Gln and Glu might be related to the fluid imbalance resulting from disruption of glucose homeostasis.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. drsanjeevsinha2002@yahoo.com.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sinha
authors.forename: Meera
authors.initials: M
authors.lastname: Ekka
authors.forename: Uma
authors.initials: U
authors.lastname: Sharma
authors.forename: Raghunandan
authors.initials: R
authors.lastname: P
authors.forename: R M
authors.initials: RM
authors.lastname: Pandey
authors.forename: N R
authors.initials: NR
authors.lastname: Jagannathan
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001923:Brain Chemistry; D002794:Choline / Q000032:analysis; D003404:Creatinine / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005947:Glucose / Q000032:analysis; D018698:Glutamic Acid / Q000032:analysis; D005973:Glutamine / Q000032:analysis; D006801:Humans; D007194:India; D007294:Inositol / Q000032:analysis; D009682:Magnetic Resonance Spectroscopy; D010865:Pilot Projects; D011446:Prospective Studies; D011522:Protons; D062606:Tertiary Care Centers
chemical_list: D011522:Protons; D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003404:Creatinine; D005947:Glucose; D002794:Choline