title: Nε-(carboxymethyl)-lysine, White Matter, and Cognitive Function in Diabetes Patients.
abstract: OBJECTIVE
  To study the relationship of Nε-(carboxymethyl)-lysine level (CML) with microstructure changes of white matter (WM), and cognitive impairment in patients with type 2 diabetes mellitus (T2DM) and to discuss the potential mechanism underlying T2DM-associated cognitive impairment.
  
  
  METHODS
  The study was performed in T2DM patients (n=22) with disease course ≥5 years and age ranging from 65 to 75 years old. A control group consisted of 25 sex- and age-matched healthy volunteers. Fractional anisotropy (FA) of several WM regions was analyzed by diffusion tensor imaging scan. Plasma CML levels were measured by enzyme-linked immunosorbent assay, and cognitive function was assessed by Mini-Mental State Examination and Montreal cognitive assessment (MoCA).
  
  
  RESULTS
  The total Mini-Mental State Examination score in the patient group (25.72±3.13) was significantly lower than the control group (28.16±2.45) (p<0.05). In addition, the total MoCA score in the patient group (22.15±3.56) was significantly lower than the control group 25.63±4.12) (p<0.01). In the patient group, FA values were significantly decreased in the corpus callosum, cingulate fasciculus, inferior fronto-occipital fasciculus, parietal WM, hippocampus, and temporal lobes relative to corresponding regions of healthy controls (p<0.05). Plasma CML level was negatively correlated with average FA values in the global brain (r=-0.58, p<0.01) and MoCA scores (r=-0.47, p<0.05).
  
  
  CONCLUSIONS
  In T2DM, WM microstructure changes occur in older patients, and elevations in CML may play a role in the development of cognitive impairment.
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Jian-Hui
authors.initials: JH
authors.lastname: Zhang
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Hong-Zeng
authors.initials: HZ
authors.lastname: Xu
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Qi-Feng
authors.initials: QF
authors.lastname: Shen
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Yong-Zhong
authors.initials: YZ
authors.lastname: Lin
authors.affiliation: 2Institute for Brain Disorder and Disease,Dalian Medical University,Dalian,China.
authors.forename: Chang-Kai
authors.initials: CK
authors.lastname: Sun
authors.affiliation: 3Department of Radiology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Lin
authors.initials: L
authors.lastname: Sha
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Yu-Song
authors.initials: YS
authors.lastname: Ge
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1Department of Neurology,Second Hospital,Dalian Medical University,Dalian,China.
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
mesh_terms: D000368:Aged; D016880:Anisotropy; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests
chemical_list: C048496:N(6)-carboxymethyllysine; D008239:Lysine
keywords: Cognitive impairment; Diffusion tensor imaging; Hippocampal atrophy; Magnetic resonance imaging; Nε-(Carboxymethyl) lysine; Type 2 diabetes mellitus