Abstract:
Abstract The metabolite changes in
the brains of children with poorly
controlled type 1 diabetes mellitus
(DM) were investigated by proton
magnetic resonance spectroscopy
(MRS). A total of 30 subjects and 14
age-matched healthy volunteers
underwent single-voxel MRS (TE:
136). The duration of disease, medication,
presence of hypoglycaemia
episodes and the level of haemoglobin
A1C (HbA1C) in the patients
were noted. Voxels were placed in
the pons, left basal ganglion (LBG)
and left posterior parietal white
matter (PPWM). N-acetylaspartate
(NAA)/creatinine (Cr) and choline
(Cho)/Cr ratios were calculated. The
average HbA1c level was 11.9±3.4
(8.2–19.4). The average number of
keto-acidosis episodes was 1.9±2.2
(0–9) and the average number of
daily insulin injections was 2.8±0.97
(2–4). MRS revealed lower NAA/Cr
and Cho/Cr ratios in the pons and
lower NAA/Cr ratio in the PPWM
of patients with DM than in control
subjects. No significant correlation
was observed between the number of
hypoglycaemia episodes and metabolite
ratios. Metabolic abnormalities
have been observed by MRS in the
brain of poorly controlled
type 1 DM children. These
metabolic changes, in particular in
the pons region, include a decrease
in NAA, indicating neuronal loss or
functional impairment, and likely
explanations for a decrease in Cho
may be dynamic changes in membrane
lipids and/or decreased
membrane turnover.
