We investigated associations of glycemic measures, and insulin resistance and secretion measures with hippocampal and subfield volumes. In this cross-sectional study, 7400 community-dwelling participants underwent brain MRI and health checkups between 2016 and 2018. Hemoglobin A1c (HbA1c), glycated albumin (GA), homeostasis model assessment for insulin resistance (HOMA-IR), and HOMA of percent β-cell function (HOMA-β) were evaluated. The associations of each measure with a smaller volume of the hippocampus and twelve hippocampal subfields were investigated. As a result, higher HbA1c or GA and lower HOMA-β levels were significantly associated with smaller volumes in multiple hippocampal subfields. Furthermore, even when we analyzed non-diabetic individuals, substantial associations remained between higher GA or lower HOMA-β levels and smaller volumes of the whole hippocampus or the fimbria. Our findings indicate that postprandial glucose fluctuations, postprandial hyperglycemia, and low insulin secretion have a specific effect on the development of smaller hippocampal volume, suggesting that primary prevention of diabetes and/or sufficient glucose control are important for the prevention of dementia.
我们研究了血糖测量、胰岛素抵抗和分泌测量与海马和亚场体积的关联。在这项横断面研究中，7400 名社区居民在 2016 年至 2018 年间接受了脑核磁共振成像和健康体检。对血红蛋白A1c（HbA1c）、糖化白蛋白（GA）、胰岛素抵抗的稳态模型评估（HOMA-IR）和β细胞功能百分比的HOMA（HOMA-β）进行了评估。研究还探讨了各项指标与海马和十二个海马亚区体积缩小的关系。结果发现，较高的 HbA1c 或 GA 以及较低的 HOMA-β 水平与多个海马亚区体积较小有着显著的关联。此外，即使我们对非糖尿病患者进行分析，较高的 GA 或较低的 HOMA-β 水平与整个海马或边缘区体积较小之间仍存在实质性关联。我们的研究结果表明，餐后血糖波动、餐后高血糖和低胰岛素分泌对海马体积变小有特定的影响，这表明糖尿病的一级预防和/或充分的血糖控制对预防痴呆症非常重要。
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