Brain research bulletin · 2026
Cerebellar gray matter volume alterations and metabolic associations stratified by disease duration in patients with type 2 diabetes.
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Yue Xiaomei, Dai Zhao, Diao Ziyu, Tan Xin, Qiu Shijun
Аннотация
AIMS: To investigate cerebellar alterations and their associations with metabolic profiles across different disease durations in type 2 diabetes mellitus (T2DM).
METHODS: This cross-sectional study included 302 healthy controls and 513 T2DM patients. T2DM patients were stratified into three groups based on disease duration, which defined as T2DM-D1 (<5 years), T2DM-D2 (5-9 years), and T2DM-D3 (≥10 years). Cerebellar segmentation was performed using Spatially Unbiased Infratentorial toolbox. Generalized linear models and partial correlation analyses were used to assess cerebellar volume differences and metabolic associations in different duration stages.
RESULTS: T2DM patients exhibited significant cerebellar atrophy (Cohen's d = -0.418 to -0.199). Duration-stratified analyses revealed distinct subgroup differences: the T2DM-D1 group had posterior-predominant atrophy (Cohen's d = -0.339 to -0.282), the T2DM-D2 group showed limited involvement, with only the left lobule X affected (Cohen's d = -0.436), and the T2DM-D3 group exhibited more widespread alterations, including lobules VIIIa, VIIb, X, IX, Crus I, and vermis IX (Cohen's d = -0.741 to -0.399). Cerebellar alterations were primarily associated with insulin and C-peptide levels in T2DM-D1, whereas they were more closely related to glycemic, renal, and lipid-related markers in T2DM-D3.
CONCLUSIONS: This study demonstrates that cerebellar alterations in T2DM vary with disease duration, accompanied by distinct metabolic profiles, underscoring the importance of duration-based stratification for individualized assessment and management.
METHODS: This cross-sectional study included 302 healthy controls and 513 T2DM patients. T2DM patients were stratified into three groups based on disease duration, which defined as T2DM-D1 (<5 years), T2DM-D2 (5-9 years), and T2DM-D3 (≥10 years). Cerebellar segmentation was performed using Spatially Unbiased Infratentorial toolbox. Generalized linear models and partial correlation analyses were used to assess cerebellar volume differences and metabolic associations in different duration stages.
RESULTS: T2DM patients exhibited significant cerebellar atrophy (Cohen's d = -0.418 to -0.199). Duration-stratified analyses revealed distinct subgroup differences: the T2DM-D1 group had posterior-predominant atrophy (Cohen's d = -0.339 to -0.282), the T2DM-D2 group showed limited involvement, with only the left lobule X affected (Cohen's d = -0.436), and the T2DM-D3 group exhibited more widespread alterations, including lobules VIIIa, VIIb, X, IX, Crus I, and vermis IX (Cohen's d = -0.741 to -0.399). Cerebellar alterations were primarily associated with insulin and C-peptide levels in T2DM-D1, whereas they were more closely related to glycemic, renal, and lipid-related markers in T2DM-D3.
CONCLUSIONS: This study demonstrates that cerebellar alterations in T2DM vary with disease duration, accompanied by distinct metabolic profiles, underscoring the importance of duration-based stratification for individualized assessment and management.