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The purpose of this study is to explore the relationship between diabetes and cognitive impairment by olfactory function assessment and functional MRI.
Previous research has shown both obesity and diabetes are associated with an increased risk of cognitive impairment. Meanwhile, olfactory impairment is associated with incident (amnestic mild cognitive impairment) aMCI and progression from aMCI to (Alzheimer disease) AD dementia. On one hand, in the cross-sectional study, biometric measurements, cognitive assessment, olfactory function and fMRI results are analysed to explore the differences among T1DM patients, T2DM patients and non-diabetic people . One the other hand, in the longitudinal study, changes in olfactory function and fMRI results in diabetic and non-diabetic obese patients both at baseline and 6 months after their bariatric surgery are collected to investigate whether better glucose and weight control benefit brain function.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Type 1 Diabetes Mellitus | These T1DM patients have late diabetes onset.(latent autoimmune diabetes in adult, LADA) |
| |
| Type 2 Diabetes Mellitus | A subgroup of these T2DM patients are obesity patients who will have the bariatric surgery. These obese T2DM subjects will undergo a physical exam, cognitive and olfactory test as well as structural and functional brain MRI at baseline and 6 months after their surgery. |
| |
| Control | A subgroup of these non-diabetic people are obesity patients who will have the bariatric surgery. These obese subjects will undergo a physical exam, cognitive and olfactory test as well as structural and functional brain fMRI at baseline and 6 months after their surgery. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive assessment | Behavioral |
| ||
| functional magnetic resonance imaging |
| Measure | Description | Time Frame |
|---|---|---|
| Participants' personal information | Self-reported information(education in years) | 1 day |
| Glycaemic control measured by blood test. | HbA1c | 1 day |
| Physical assessments. | BMI(body mess index) in kg/m^2 | 1 Day |
| Olfactory threshold test | Olfactory threshold test: The same odor with 2 different concentrations are given to the participant each time to find out which one is more intense. (Olfactory software will analyse and give threshold score depending on participant's choice.) | 1 day |
| Olfactory memory test: | PART A: Participants are shown 4 pictures for each odor(10 odors in total). They select what they sniffed. 10 minutes break. PART B: Participants sniff 20 different odors , 10 of which are same odors in PART A. They select the picture and figure out whether the odor is old or new. | 1 day |
| Montreal Cognitive Assessment (MoCA) | The MoCA is a cognitive screening test designed to assist Health Professionals in detection of mild cognitive impairment. | 1 Day |
| Functional MRI of the brain tracking testing. | 1day |
| Measure | Description | Time Frame |
|---|---|---|
| Change form baseline Glycaemic control measured by blood test. | HbA1c | 6 months after the bariatric surgery (for diabetic and non-diabetic obese patients) |
| Change from baseline Functional magnetic resonance imagine |
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Inclusion Criteria:
Exclusion Criteria:
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T1DM(latent autoimmune diabetes in adult,LADA) and T2DM patients.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| at Division of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University | Nanjing | Jiangsu | 210008 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39843980 | Derived | Zhao Q, Maimaitiaili S, Bi Y, Li M, Li X, Li Q, Shen X, Wu M, Fu L, Zhu Z, Zhang X, Chen J, Hu A, Zhang Z, Zhang W, Zhang B. Brain Iron Deposition Alterations in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment Based on Quantitative Susceptibility Mapping. J Diabetes. 2025 Jan;17(1):e70052. doi: 10.1111/1753-0407.70052. | |
| 36306532 |
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| Other |
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| olfactory function measurement | Other |
|
| bariatric surgery | Procedure | Only a subgroup of the subjects will have the bariatric surgery. |
|
| 6 months after the bariatric surgery (for diabetic and non-diabetic obese patients) |
| Miao Y, Wang J, Zhang B, Zhang W, Xu X, Hou Y, Ding Q, Yu C, Zhang Z, Bi Y, Zhu D. Altered brain spontaneous and synchronization activity in latent autoimmune diabetes in adults: A resting-state functional MRI study. Diabetes Metab Res Rev. 2023 Jan;39(1):e3587. doi: 10.1002/dmrr.3587. Epub 2022 Nov 7. |
| 33751221 | Derived | Zhang W, Gao C, Qing Z, Zhang Z, Bi Y, Zeng W, Zhang B. Hippocampal subfields atrophy contribute more to cognitive impairment in middle-aged patients with type 2 diabetes rather than microvascular lesions. Acta Diabetol. 2021 Aug;58(8):1023-1033. doi: 10.1007/s00592-020-01670-x. Epub 2021 Mar 22. |
| 31221697 | Derived | Zhang Z, Zhang B, Wang X, Zhang X, Yang QX, Qing Z, Zhang W, Zhu D, Bi Y. Olfactory Dysfunction Mediates Adiposity in Cognitive Impairment of Type 2 Diabetes: Insights From Clinical and Functional Neuroimaging Studies. Diabetes Care. 2019 Jul;42(7):1274-1283. doi: 10.2337/dc18-2584. Epub 2019 May 21. |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D060825 | Cognitive Dysfunction |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000073216 | Mental Status and Dementia Tests |
| D050110 | Bariatric Surgery |
| ID | Term |
|---|---|
| D009483 | Neuropsychological Tests |
| D011581 | Psychological Tests |
| D004191 | Behavioral Disciplines and Activities |
| D049088 | Bariatrics |
| D000073319 | Obesity Management |
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
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