A Cross-sectional Study on the Correlation Between Serum Sulfate Ion Levels and Brain Function in Patients With Diabetic Encephalopathy
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 220
- 主要终点
- Serum sulfate ion levels
研究概览
简要总结
The goal of this observational study is to learn about the relationship between sulfate ion levels in the blood and brain function in people with diabetic encephalopathy, a diabetes-related brain condition that can affect thinking and memory. The main questions it aims to answer are:
- Are blood sulfate ion levels related to memory and thinking test scores?
- Are blood sulfate ion levels related to the severity of brain shrinkage (brain atrophy) seen on MRI?
- Do sulfate ion levels and their relationship with thinking and memory differ among people with different levels of long-term blood sugar control? Researchers will compare participants grouped by long-term blood sugar control (based on HbA1c, a blood test that reflects average blood sugar over the past 2-3 months) to see whether sulfate ion levels and their associations with brain function differ.
Participants will:
- Give a blood sample to measure sulfate ion levels, HbA1c, and neurofilament light chain (NfL), a marker of nerve damage.
- Complete the Montreal Cognitive Assessment (MoCA), a test of memory and thinking, and questionnaires about daily living skills.
- Have a brain MRI scan to assess brain shrinkage, unless a recent scan within the past 6 months can be used.
- Provide information about their diabetes and medical history. This is a cross-sectional study, so participants will be assessed once at enrollment. No treatment or intervention is given. About 220 adults aged 45-75 years with type 2 diabetes and diabetic encephalopathy will take part.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 45 Years 至 75 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 45-75 years, no restriction on sex; patients with type 2 diabetes mellitus who meet the current American Diabetes Association (ADA) Standards of Care in Diabetes or the World Health Organization (WHO) diagnostic criteria for diabetes, with a confirmed disease duration ≥ 6 years.
- •Cranial plain magnetic resonance imaging (MRI; sequences including at least T1WI, T2WI, and FLAIR) with a radiological report indicating age-inappropriate brain atrophy (e.g., ventricular enlargement, widened sulci). Concomitant prior cerebral infarction or cerebral small vessel disease changes (e.g., lacunar infarction, white matter hyperintensities, etc.) are allowed. Other major structural causes that may lead to cognitive impairment, such as cerebral hemorrhage and space-occupying lesions, are excluded. Patients with acute cerebral infarction at least 2 weeks after onset, with stable vital signs and metabolic status, who are able to complete the MoCA assessment and MRI examination, are allowed.
- •Montreal Cognitive Assessment (MoCA) score <
- •Education level of primary school or above; able to communicate well with the investigators and comply with all study requirements.
- •Voluntarily participate in this study and provide signed informed consent.
排除标准
- •Patients with type 1 diabetes, gestational diabetes, other specific types of diabetes, or participants with unknown diabetes status.
- •Cognitive impairment caused by other definite etiologies (e.g., Alzheimer's disease, Lewy body dementia, frontotemporal dementia, central nervous system infection, severe traumatic brain injury, poisoning, etc.).
- •Severe infection, major trauma, or surgery within 3 months; active malignancy (except localized skin cancer); or acute or severe systemic diseases that may significantly affect metabolic status or cognitive function.
- •Major depressive disorder, schizophrenia, or other psychiatric disorders or delirium that may affect the assessment of cognitive function.
- •Severe hepatic or renal insufficiency (e.g., ALT or AST > 3 times the upper limit of normal, eGFR < 30 mL/min/1.73 m²).
- •Severe hearing or visual impairment, MRI contraindications, or any other condition that prevents cooperation with the examinations.
研究组 & 干预措施
Diabetic encephalopathy
Adults aged 45-75 years of either sex with type 2 diabetes mellitus for ≥6 years and diabetic encephalopathy, defined as MoCA <26 plus MRI evidence of age-inappropriate brain atrophy after excluding other structural causes. Concomitant prior cerebral infarction or small vessel disease changes are allowed. Approximately 220 participants will be enrolled and assessed once at enrollment (cross-sectional), including serum sulfate ion, NfL, HbA1c, MoCA, ADL/IADL, and brain MRI.
干预措施: This study does not involve any treatment or intervention. (Other)
结局指标
主要结局
Serum sulfate ion levels
时间窗: At enrollment (single blood draw; cross-sectional assessment)
Serum sulfate ion concentration, measured in mmol/L by ion chromatography. Analyzed as a continuous variable; no predefined minimum or maximum. Higher values indicate higher serum sulfate ion levels.
Long-term glycemic control (HbA1c)
时间窗: At enrollment (reflecting glycemic control over the preceding 2-3 months)
Glycated hemoglobin (HbA1c) level, measured as a percentage (%) by a standardized assay. Reflects average blood glucose over the preceding 2-3 months. Analyzed as a continuous variable; higher values indicate poorer long-term glycemic control.
Brain function: MoCA total score
时间窗: At enrollment (single cross-sectional assessment)
Total score on the Montreal Cognitive Assessment (MoCA). Scores range from 0 to 30, with higher scores indicating better cognitive function.
Brain atrophy assessed by cranial MRI
时间窗: At enrollment; baseline MRI, or prior MRI within 6 months if it meets study criteria
Brain atrophy assessed on cranial MRI (T1WI, T2WI, FLAIR) by experienced radiologists using standardized visual rating scales (e.g., MTA, GCA, and/or Evans index). Severity graded as none, mild, moderate, or severe, or per the selected validated scale; higher grades indicate more severe atrophy (worse outcome).
Montreal Cognitive Assessment (MoCA) visuospatial/executive function score
时间窗: At enrollment (single cross-sectional assessment)
Visuospatial/executive function domain score on the MoCA. Scores range from 0 to 5, with higher scores indicating better visuospatial/executive function.
Montreal Cognitive Assessment (MoCA) naming score
时间窗: At enrollment (single cross-sectional assessment)
Naming domain score on the MoCA. Scores range from 0 to 3, with higher scores indicating better naming ability.
Montreal Cognitive Assessment (MoCA) attention score
时间窗: At enrollment (single cross-sectional assessment)
Attention domain score on the MoCA. Scores range from 0 to 6, with higher scores indicating better attention.
Montreal Cognitive Assessment (MoCA) language score
时间窗: At enrollment (single cross-sectional assessment)
Language domain score on the MoCA. Scores range from 0 to 3, with higher scores indicating better language function.
Montreal Cognitive Assessment (MoCA) abstraction score
时间窗: At enrollment (single cross-sectional assessment)
Abstraction domain score on the MoCA. Scores range from 0 to 2, with higher scores indicating better abstract reasoning.
Montreal Cognitive Assessment (MoCA) delayed recall score
时间窗: At enrollment (single cross-sectional assessment)
Delayed recall domain score on the MoCA. Scores range from 0 to 5, with higher scores indicating better memory.
Montreal Cognitive Assessment (MoCA) orientation score
时间窗: At enrollment (single cross-sectional assessment)
Orientation domain score on the MoCA. Scores range from 0 to 6, with higher scores indicating better orientation.
次要结局
- Barthel Index total score(At enrollment (single cross-sectional assessment))
- Instrumental Activities of Daily Living Scale (IADL) score(At enrollment (single cross-sectional assessment))
- Serum neurofilament light chain (NfL) level(At enrollment (single blood draw; cross-sectional assessment))
研究者
Ying Gao
Profressor
Dongzhimen Hospital, Beijing
