Cerebrovascular diseases in the context of type 2 diabetes mellitus: cognitive impairment and associated brain status and metabolic characteristics
Bibliographic record
Abstract
A significant trend in modern medicine is heterogeneous cognitive impairment (CI). The extremely pressing issue of cerebro-metabolic health and CI, especially against the backdrop of type 2 diabetes mellitus (DM2), is currently the focus of neurology. Objective : to evaluate CI, as well as the associated brain status and metabolic characteristics in patients with various manifestations of cerebrovascular disease (CVD) against the background of type 2 diabetes mellitus. Material and methods . Patients with CVD (n=151) were divided into groups depending on the presence or absence of DM2. The first group (n=69; age – 63.0 [58.0; 69.0] years) consisted of patients with CVD combined with DM2. The second group consisted of 82 patients with isolated CVD (age – 62.5 [57.0; 68.0] years). Clinical and neurological examinations, neuropsychological testing, laboratory tests (including assessment of metabolic parameters and calculation of the triglyceride-glucose index – TyG index) and magnetic resonance imaging (MRI) of the brain were performed. Results . The worst cognitive function (CF) assessment results were recorded in patients with CVS and DM2: Montreal Cognitive Assessment (MoCA) score – 25 [23; 26] points versus 27 [25; 28] points (p<0.001), on the Addenbrooke's Cognitive Examination Scale III (ACE-III)– 87 [80; 89] points versus 90 [84; 94] points (p=0.002). During MRI, more significant changes in the form of white matter hyperintensity (WMH) on the Fazekas scale and other neuroimaging patterns were also noted in patients with DM2: Fazekas III brain damage in 23.2% of patients, Fazekas II in 36.2%, Fazekas II–III – in 59.4% (in patients without DM2 – 7.3; 19.5; 26.8% of observations, respectively; p<0,001). In patients with WMH, the presence of DM2 is associated with a decrease in CF: MoCA – 24 [22; 26] points versus 27 [25; 28] points (p=0.013); ACE-III – 87 [80; 89] points versus 92 [84; 95] points (p=0.012). The severity of CI is correlated with the level of TyG index. Combined cerebro-metabolic status (WMH and TyG index ≥4.825) in patients with CVD was accompanied by more severe CI, with 79.2% of individuals having MoCA <26. Conclusion . The combination of CVD and type 2 diabetes mellitus is characterised by an unfavourable cerebro-metabolic status in the form of significant damage to brain tissue and changes in carbohydrate/lipid metabolism parameters (glucose lipotoxicity) and is associated with more pronounced CI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".