Amagqabantshintshi: Ukutya okukhoyo okukhokelela ekutyebeni kunokubangela utshintsho oluninzi kubuchopho. Utshintsho olunye lubandakanya ukunyuka komba omhlophe (myelin) kwi-striatum (isahlulo sesekethe yomvuzo). Ukuhambisa ukutya kunciphisa umba omhlophe, kubonakalisa ukuba olutshintsho luyaphindeka.
Ishicilelwe kwi-Intanethi ngaphambi kokuprinta ngoMeyi 29, 2007, doi: 10.1210 / jc.2006-2495 Ijenali ye-Clinical Endocrinology & Metabolism Agasti 1, 2007 vol. 92 hayi. 8 3278-3284
- UkuBambisana noMbhali
Amasebe e-Neurology (LTH, NK, VK), Unyango lwangaphakathi (AV, PN), kunye neRadiology (RP), iYunivesithi yaseTurku, FIN-20521 Turku, eFinland; IZiko le-PET laseTurku (LTH, AV, NK, JOR, PN, VK), FIN-20521 Turku, eFinland
- Dlulisa yonke imbalelwano kunye nezicelo zokuphinda ubhale ku: Gqirha Lauri T. Haltia, iZiko le-PET laseTurku, iYunivesithi yaseTurku, I-PO Box 52, FIN-20521 Turku, eFinland. I-imeyile: [imeyile ikhuselwe].
Abstract
Umxholo kunye Injongo Ukutyeba kunxulunyaniswa nokuxinana okuninzi kwemetabolism. Izifundo zamva nje zibonisa ukuba ukutyeba kakhulu kuchaphazela ukusebenza kwengqondo kwaye kungumngcipheko kwezinye izifo zobuchopho obuthathaka. Iinjongo zolu phononongo yayikukujonga iziphumo zokufumana ubunzima kunye nokwehla kobunzima kubugqwetha bengwevu nemicimbi emhlophe. Siye safumanisa ukuba umahluko obonakalayo obonakalayo kwiingqondo zezifundo ezingamanyala unokuphelelwa okanye unciphe emva kwexesha lokutya.
Iindlela: Kwinxalenye yoku-1 yesifundo, sigqogqe ngemibono ye-magnetic resonance imaging 16 lean (nditsho isalathiso sobunzima bomzimba, i-22 kg / m2) kunye ne-30 obese (kuthetha ukuba isalathiso sobunzima bomzimba, i-33 kg / m2Izifundo ezisempilweni. Kwisahlulo II, izifundo ze-16 ezi-feta ziyaqhubeka nokutya okunekhalori ephantsi kakhulu ye-6 wk, emva koko kuskenwe kwakhona. Umthamo wengqondo emhlophe kunye nengwevu imiba ebalwa kusetyenziswa i-voxel-based morphometry.
iziphumo: Iivolumu zemicimbi emhlophe zazininzi kwizifundo ezityebileyo, xa kuthelekiswa nezifundo ezinqabileyo kwimimandla eliqela yobuchopho obusisiseko, kwaye abantu abatyebe kakhulu babonisa ulungelelwaniso olufanelekileyo phakathi komthamo wemicimbi emhlophe kulwakhiwo lobuchopho basal kunye nasesinqeni ukuya kumyinge wehip. Ulwandiso lwezinto ezimhlophe ezifunyenweyo zahluthwa inxenye ngokutya. Umthamo wemicimbi engwevu yengingqi awuzange wahluka kakhulu kwizifundo ezi-oese kunye ezinobunewunewu, kwaye ukutya ukutya akuchaphazelekanga grey.
Izigqibo: Indlela echanekileyo yotshintsho lomba omhlophe ofunyenweyo ihlala ingacacanga, kodwa isifundo esikhoyo sibonisa ukuba ukutyeba kakhulu kunye nokutya kukunxulunyaniswa notshintsho olwenziweyo kubume bengqondo. Akukhutshelwa ngaphandle ukuba ukwandiswa komcimbi omhlophe ekutyebiseni kunendima kwi-neuropathogenesis yezifo zobuchopho ezibuthathaka.
UKUGCINWA KUFANELEKILEYO ngotshintsho ekubumbeni komzimba kunye nokunyuka kwe-visceral kunye ne-sc fat. Ukuqokelelwa kwamafutha omzimba kunxulunyaniswa nokuxhatshazwa okuninzi kwe-metabolic, okunokubeka phambili kwizifo ezinje ngohlobo lwesifo seswekile se-2, uxinzelelo lwegazi, ukubetha, kunye nomhlaza. Inkqubo ye-nervous central yokutshintsha kokukhuluphala ayaziwa kakuhle, nangona izifundo zepsychology zibonisa unxibelelwano phakathi kwezifo ezithile zobuchopho obuthathaka kunye nokukhuluphala. Ukunyusa ubunzima bomzimba kuyaziwa ngokuba yinto yomngcipheko wokwehla kwengqondo (1, 2kunye nesifo se-Alzheimer's (3), kunye nonxibelelwano phakathi kokukhuluphala kunye nesifo sengqondo esixhalabisayo esizimeleyo kwezinye iimeko zekomorididi (4). Ukutyeba kakhulu kunokuthi kunxulunyaniswe nomngcipheko ophezulu wokuphazamiseka kwemithambo-luvo, njengesifo sikaParkinson (5). Inkqubo ye pathophysiological esekwe kulwalamano oluntsonkothileyo ingaqondwa kakuhle, kodwa unxibelelwano olunye olunokubakho phakathi kokukhuluphala kunye nezifo zokuthomalalisa kukukhula kokunganyangeki kwe-insulin kunye / okanye isifo seswekile, ichaphazela ukuqonda (1).
Ngenxa yoko, izifundo eziphathelele kwizifo zobuchopho ezibuthathaka zixhasa umbono wokuba ukutyeba kunefuthe elibi ekusebenzeni kwengqondo, kwaye kukho nezifundo zabantu ezibonakalisa umahluko wokusebenza kwengqondo phakathi kokuziphatha okunesidima kunye nabantu abangaqhelekanga. Izifundo zokulinganisa kunye ne-positron emission tomography (PET) kunye nokusebenza kwengqondo esebenzayo ye-resonance imaging (fMRI) ifumanise ukuba ukukhuluphala kunxulunyaniswa notshintsho ekuhambeni kwegazi lobuchopho kunye ne-neurochemistry. Isifundo se-PET kunye [11C] i-raclopride ibonakalise ukuba ukubakho kwengqondo ye-dopamine D2 receptors yabantu abatyebe kakhulu kuyancipha ngokuhambelana nesalathiso sobunzima bomzimba wabo (BMI) (6). Izifundo ezisebenzisa i-PET kunye namanyathelo okuhamba kwegazi kwisangqa yecandelo kubonise iimpendulo ezahlukeneyo zobuchopho kwisimo sabantu abanamanyala kunye nabazondeleleneyo (7, 8), kwaye uphononongo lwe-FMRI lubonise ukuba i-glucose ingestion ingena kwisithinteli somqondiso we-FMRI kumacandelo e-hypothalamus nokuba le mpendulo inhibitory ephambili iphawulwe kakuhle kwizifundo ezi-feta (9). Olunye uphononongo lwe-FMRI lubonise inani elikhulu leendawo zokusebenzisa ubuchopho kwabo batya ngokutya kakhulu (xa kuthelekiswa nokutya okuneenkani kunye nabadla abangathathi ntweni) ukuphendula ukubonwa nokungcungcutheka kokutya.10). Ukongeza, olunye uphononongo oludlulileyo kunye ne-single Photon emission Tomography lubonise ukuba ukubonwa ngokubonakalayo kukutya kunxulunyaniswa nokunyuka kwegazi kwisangqa sokuhamba kwe-cortices ye-temporal ye-temporal kunye ne-parietal cortices ekunene kwabasetyhini abakhulu kodwa hayi abafazi abaqhelekileyo (11). Uphononongo lwakutshanje nolwenziwe ngemagnetry imaging (MRI) kunye ne-voxel-based morphometry (VBM) lubonise ukuba abantu abatyebileyo banciphise kakhulu umthamo wegreythi yengqondo kwigrasi yangaphambili, i-operculum yangaphambili, i-putamen, kunye ne-gyrus ephambili yangaphambili. Izifundo ezinobunkunkqele, kunye nokuba i-BMI kwizifundo ezi-oese (kodwa ezingakhathaliyo) ayinxulunyaniswa ngokungafanelekanga nomthamo wempunga yomsonto wesobunxele oshiyekileyo (12). Kwakhona, umahluko kumthamo wemicimbi emhlophe wafunyanwa kwindawo ekufutshane ne-striatum, apho izifundo ezi-feta zinomthamo omkhulu kunezifundo ezirhabaxa.
Uninzi lwezifundo zokucinga ngengqondo ezinobunzima kakhulu kukuthelekiswa kweqela. Rhoqo amaqela ahlulekile ngokwe-BMI, kunye nokwahlulwa kwenkqubo yangaphakathi yeesistim, umz ukuhamba kwegazi lengingqi, ii-dopamine receptors okanye i-grey factor volume, kufundwe ngendlela enqamlezayo. Kulwazi lwethu, akukho luhlalutyo lwe longitudinal lomsebenzi wobuchopho kwi-obesity. Kwisifundo esikhoyo, sasinomdla kwiziphumo zokufumana ubunzima kunye nelahleko kwingqondo yomntu engwevu kunye nobumhlophe bemicimbi. Iiphospholipids zizinto eziphambili ze-membrane ye-neuronal kunye ne-glial membrane, kwaye zithathe inxaxheba kulungiso lwe-membrane kunye nokuqalwa kunye nokuhanjiswa komqondiso (13). Imetabolism yengqondo phospholipids yinkqubo eguqukayo, echatshazelwa, umzekelo, ingqokelela ye-plasma yamafutha asimahla. Malunga ne-5% yamanqatha angenazintso akhutshwa kwigazi njengoko lidlula kwingqondo ye-rat, kwaye ukuhanjiswa kuzimeleyo kukuhamba kwegazi leswekile (13). Ukutyeba kuhamba kunye nokugqithiswa kwamafutha asimahla kwi-plasma evuselela ekuqokeleleni kwamafutha kwii-adipocytes kunye nakumalungu athile. Ke ngoko, siye safumanisa ukuba abantu abatyebileyo banakho umahluko kubuchwephesha bamafutha engqondo kunye nokunyuka kokuqokelelwa kwamafutha kumcimbi omhlophe, kwaye oku kunokubonakalisa ivolumu yomcimbi omhlophe.
Olu phononongo lwalungiselelwe ukuba lube nenxalenye ezimbini: i-1) ingqokelela yengqondo yecandelo eliqingqiweyo lobuchwephesha obumdaka kunye nozimeleyo kunye nohlalutyo lokunxibelelana, kunye ne-2) ulandelo lwe-longitudinal yeengqondo zomntu emva kokulahleka komzimba ngokukhawuleza okukhulu. Ngokwenxalenye yokuqala, siphande ngumahluko kubume bengqondo engwevu nengwemhlophe phakathi komntu ojijekileyo kunye notyebileyo. Kwisahlulo II, ukuthathwa kwabantu abatyebileyo (n = 16) ukusuka kwinxalenye yokuqala baqalisa ukutya okune-calorie ephantsi kakhulu (VLCD) ye-6 wk, kunye nokulandelelwa kwengqondo kwesibini emva kokuba behlise ngempumelelo ubunzima babo ngomndilili nge-12 % Ukuhambisa umzimba kuyaziwa ukuba kunefuthe eliluncedo, umzekelo, ubuntununtunu be-insulin kunye neeplasma lipids kubantu abatyebileyo (14), kunye nokucutha ubunzima kunxulunyaniswa nokwehliswa kwenqanaba leplin plasma (15). Ubongo, njengezicubu ezityebileyo ze-lipid, zinokuchaphazeleka kukuncipha komzimba. Sivavanye ukuba ukunciphisa ubunzima kunganciphisa umthamo wobuchopho kwizifundo ezi-feta ngokuhambelana nokuncitshiswa kwamafutha emzimbeni wonke.
Izifundo kunye neendlela
Izihloko kunye noyilo lokufunda
Icandelo Mna.
Uphononongo lubandakanye i-30 i -ese (i-12 yamadoda kunye nabafazi be-18) kunye ne-16 lean (amadoda asibhozo kunye nabasetyhini abasibhozo) izifundo. Abantu abaziindlamanzi bachazwa njengabo bane-BMI engaphantsi kwe-26 kg / m2 kunye nabantu abatyebe kakhulu abane-BMI enkulu kune-27 kg / m2. Izigulana ezinengxaki yokutya, izifo zemetabolism, isifo sentliziyo, isifo se-hepatic esedlule okanye sangokuphinda sisebenze, i-anemia, okanye unyango lwe-corticosteroid yomlomo ngaphandle. Iimpawu eziphambili zomzimba kunye ne-metabolic yezifundo zibonakaliswe kwiTafile 1⇓. Abantu abatyeba kakhulu babene-glucose kakhulu, i-insulin, i-leptin, kunye namafutha asimahla (iTheyibhile 1)⇓). Imvume ebhaliweyo ebhaliweyo yafunyanwa emva kokuchazwa kwenjongo kunye nomngcipheko wokufunda kwizifundo. Inkqubo yokufunda yamkelwa yikomiti yokuziphatha ye-Southwest Finland Healthcare District kwaye iqhutywa ngokwemigaqo yokubhengezwa kweHelsinki.
Iimpawu eziphambili zedemokhrasi kunye nexabiso laselebhu (emva kokuzila) kwezifundo ezifundwayo
Icandelo II.
Izifundo ezilishumi elinantandathu ezityebileyo (amadoda amane kunye nabasetyhini be-12) ukusuka kwinxalenye ndithathe inxaxheba kwisigaba II, ngexesha apho bamiselwa i-VLCD (Itheyibhile 2⇓). Zonke izidlo zemihla ngemihla zitshintshwe iimveliso zeVLCD kangangexesha le-6 wk (Nutrifast; Leiras Finland, Helsinki, Finland) (2.3 MJ, 4.5 g fat, 59 g protein, and 72 g carbohydrate ngemini). Yongezwa kwi-Nutrifast, izifundo zisela imihla ngemihla iilitha zamanzi ze-2 okanye iziselo ezineshukela ezingenaswekile. Akukho lutshintsho kwimisebenzi yomzimba evunyelwe. Ukutya bekuhlala kulawulwa ngunesi ofundayo onobuchule kwezesondlo. Emva kokutya kukho ixesha lokubuyiselwa kwe-1-wk kunye nokutya okuqhelekileyo kwe-metocaloric ukuphepha imeko ye-catabolic. I-MRI, imilinganiselo ye-anthropometric, kunye novavanyo lwelebhu lwaphindwa emva kwexesha lokubuyisela. Imasisi ye-tishu ye-Adipose kwindawo yesisu yavavanywa kwinqanaba le-L2 / L3 i-diski ye-intervertebral yediski ngaphambi nasemva kokutya ngokutya kusetyenziswa indlela emiselweyo esekwe kwi-MRI (16).
Ukulinganisa kunye nohlalutyo lwedatha
Ii-MRIs zafunyanwa kunye noPhilips Gyroscan Intera 1.5 T CV Nova Dual scanner (uPhilips, Best, Netherlands). Idatha ye-T1 enomqondo opheleleyo enobunzima obuthathu-encinci ye-echo (FFE) yedatha yafunyanwa kwindiza enqumlayo (ixesha lokuphindaphinda = 25 msec, ixesha echo = 5 msec, flip angle = 30 °, inani leemincili (NEX) = 1, kunye nembonakalo yokujonga = 256 × 256 mm2), ukuvelisa ubuncinci i-160 izilayi zeseli entloko. Imifanekiso idluliselwe kwikhompyuter yakho kwaye iguqulwe ibe nguHlalelo lwefomathi kusetyenziswa iMRIconvert (http://lcni.uoregon.edu/∼jolinda/MRIConvert/) kwaye kuhlalutywe kusetyenziswa i-SPM2 (iSebe lezeMpilo leNgcaciso yeLungelo lokuqonda, eLondon, e-UK; http // www.fil.ion.ucl.ac.uk / spm) kunye noMatlab 6.5 (I-MathWorks, Natick, MA). Iprothokholi ye-VBM eyenziwe kakuhle yasetyenziswa kwimifanekiso (17). Ngaphambi kohlalutyo lweVBM, uvavanyo lweklinikhi lokujonga imifanekiso ye-MR lwenziwa ngugqirha onamava we-neuroradiologist (RP). Isifundo esinye esalupheleyo esine-lean lacunar infarct kufutshane ne-cortex yesobunxele yasekhohlo; Azikho ezinye iziphumo ezibalulekileyo zophando eziye zaqwalaselwa kuso nasiphi na isifundo.
itemplates
Iitemplate ezenziwe ngokwezifiso zenziwa ukuba zenze kube lula ukwenziwa okuqhelekileyo kunye nesahluko se-MRI izikrini zee-oese kunye nezifundo ezinomtsalane. Isizukulwana seetemplate senziwa kusetyenziswa ulwandiso lwebhokisi yezixhobo kwisahlulo se-algorithm se-SPM2 (uChristian Gaser, kwiYunivesithi yaseJena, eJena, eJamani; http://dbm.neuro.uni-jena.de/vbm/). Iitemplate zakhiwa kuba umahluko wezinto ezikhoyo ze-MRI zisenokwahluka kwitemplate ekhoyo, amanani abantu besifundo esikhoyo anokwahluka kulawo asetyenziswayo ukuvelisa itemplate ekhoyo, kwaye iskena ngasinye sazisa okungafaniyo kunye ne-inhomogeneities. Iitemplate ke ngoko zakhiwa kumzamo wokunciphisa ukubanakho kokukhetha kwiqela elinye ngexesha lokwehla kwesiqhelo (18).
I-VBM eyenzelwe ngokufanelekileyo
Emva kokudalwa kweetemplate ezikhethekileyo ezifundwayo, iprothokholi elungiselelwe ukusebenza yafaka idatha yoqobo (17). Iprothokholi ye-VBM eyenziwe kakuhle iphucula imeko yesiqhelo ngokusetyenziswa kwemifanekiso engwevu kunye netemplate yomba ongwevu kunokuba ibe yimifanekiso ye-T1 ye-anatomical. Iprothokholi eyakhelweyo ikwabandakanya ukucocwa kokwahlulahlulahlulo ngokusebenzisa imisebenzi ye-morphological kunye nokuguqulwa kokukhetha kweesahlulelo ukugcina inani elipheleleyo lesiginali. Ngenxa yokuba sasinomdla ikakhulu kwiyantlukwano yokuguquguquka kwengxaki yokukhuluphala kunotyekelo lokugxininisa, sikhethe ukusebenzisa uguquko olwongezelelweyo kwiprotocol yethu yeVBM. Ukupheliswa kwento yesiqhelo kwindawo ye-25 mm, kusetyenziswa i-nonlinear frequency, kunye nomgaqo obandakanyekayo kwi-16 nonlinear iterations. Imifanekiso eguqulweyo yaphuculwa nge-12-mm epheleleyo ububanzi kwisiqingatha esiphezulu (FWHM) isotropic Gaussian kernel. Kwizifundo zangaphambili, i-VBM eyenziwe yaqinisekiswa ngokufanelekileyo, kwaye indlela yokuhlelwa kwezicubu esetyenziswe kwiVBM ivelise iziphumo ezihle kakhulu (17).
Uhlalutyo lwezinto eziphilayo
Ukugxininiswa kweglucose ye-Plasma kumiselwe kwimpinda kabini ngendlela ye-glucose oxidase (ukuhlaziywa kwe-Analox GM9; Analox Instruments, London, UK). I-hemoglobin ye-Glycosylated ilinganiswe ngeproteinograig yolwazi olukhawulezayo (MonoS; Pharmacia, Uppsala, Sweden). Uxinzelelo lwe-insulin ye-plasma ilinganiswe ngu-fluoroimmunoassays ophindwe kabini (Autodelfia; Wallac, Turku, Finland). I-Serum iyonke cholesterol kunye ne-high-density lipoprotein cholesterol yalinganiswa kusetyenziswa iindlela ze-enzymatic ezisemgangathweni (I-Roche Molecular Biochemicals, Mannheim, Germany) kunye nohlalutyo oluzenzekelayo (uHitachi 704; Hitachi, Tokyo, Japan). I-Serum esezantsi-density lipoprotein cholesterol yabalwa ngokwe-Friedewald equation (19). I-serum yamafutha asimahla yama-acid yamiselwa yindlela ye-enzymatic (indlela ye-acyl-CoA i-synthase-acyl-CoA oxidase peroxidase; Wako Chemicals, Neuss, Germany). I-Plasma leptin yahlaziywa kunye ne-RIA (iLinco, iSt. Charles, MO). Kwinxalenye yokuqala, idatha yovavanyo lwegazi, ukujikeleziswa kwesinqe, kunye nokuma komlenze ukuya kwinqanaba lomjikelezo yayingafumaneki kwizifundo ezine ezinobunzima kwaye idatha ye-leptin yayilahlekile kwisifundo esinye esidala.
Uhlalutyo lwesatisatisti
Idatha ephuculweyo, eguqulweyo yaphononongwa kusetyenziswa imephu yezibalo ze-parametric (SPM2) kusetyenziswa imodeli yomgca ngokubanzi. Utshintsho lwe volumetric lwavavanywa ngohlalutyo lwedatha emodareyithiweyo. Kungenxa yokuba ngexesha lokumodareyitha sidibanisa ukulungiswa kotshintsho lwevolumu olwenziwe yindawo eqhelekileyo, kufanelekile ukubandakanya ivolumu ye-intracranial (TIV) njenge-covariate yokususa nayiphi na iyantlukwano ngenxa yomehluko kubukhulu bentloko. I-TIV ibalwe kusetyenziswa i-Get_globals function ye-SPM2. Inani lee-voxels kwikharethi nganye yezitena yabalwa kwaye yashwankathelwa.
Uhlalutyo lweenkcukacha-manani, ii-voxels ezinexabiso lezinto ezingwevu okanye zimhlophe ezingaphantsi kwe-0.1 azifakwanga ukunqanda iimpembelelo ezinokubakho kumda ophakathi komda ompunga nomhlophe. Umahluko phakathi kweziganeko ezirhabaxa nezirhabaxa zavavanywa ngohlalutyo lobugcisa bokusebenzisa isondo kunye ne-TIV njengezinto ezihlasimlis 'umzimba. Uhlalutyo oluhlalutyo phakathi kwemilinganiselo yomzimba / ye-metabolic kunye nengqondo emhlophe / grey kwimiba emhlophe yenziwa ngohlalutyo oluninzi lokuhlaziya kusetyenziswa isondo kunye ne-TIV njengezinto ezihlasimlis 'umzimba. Iziphumo zokutya kwimicimbi emhlophe nengwevu zavavanywa nge-paired t iimvavanyo ngaphakathi kwe-SPM2. Uhlalutyo lwe-Correlation lwenxalenye yesibini ye-II lwenziwa ngokubhalwa ngokulula ngokubala imifanekiso ye-delta (iskena i-1 - iskena 2) kunye namaxabiso emilinganiselo yamayeza kunye nemilinganiselo yemetabolism. Umda ophakamileyo kuhlalutyo lwe-SPM wabekwa khona P = I-0.01 kunye nomda wokubambisa i-voxels ze-50. Indawo esetyenziswayo ye-MNI (uSergey Pakhomov, iRussian Academy yezeNzululwazi, iSt. Petersburg, iRussia) ulwandiso lwe-SPM lwalusetyenziselwa ukutolika ii-SPMs kunye nokuchonga iilebhile ezifanelekileyo zomzimba. Inqanaba lokubaluleka kokubalwa kumgangatho we-voxel-ulungisiwe P <0.01 [ilungisiwe kuthelekiso oluninzi kusetyenziswa inqanaba lokufumanisa okungamanga (FDR)]. Idatha iboniswa njengeendlela (sd), ngaphandle kokuba kuboniswe ngenye indlela.
iziphumo
Ingqondo yenqila yengingqi kwizifundo ezirhabaxa nezinamafutha (icandelo I)
Amanqaku amakhulu omqondo wobuchopho omhlophe aqwalaselwe kwizifundo ezi-feta, xa kuthelekiswa nezifundo ezinqabileyo, kwimimandla eliqela: eliphakamileyo, eliphakathi neliphantsi gyri yokwexeshana; fusiform gyrus; parahippocampal gyrus; isiqu sobuchopho; kunye ne-cerebellum (zonke iziphumo zifunyenwe kabini) (Fig. 1⇓, A no-B). Kwimephu yengqondo ye-SPM, ii-voxel ezidityanisiweyo ezinomahluko omkhulu kwiqela lezinto ezimhlophe ezimiselweyo zenza amaqela amabini [I-35,901 ii-voxels, i-voxel ephezulu (kwi-6 mm, −23 mm, −29 mm), FDR isilungisiwe P = 0.006; I-voxels ze-16,228, i-voxel ephezulu (kwi-−52 mm, −18 mm, −28 mm), i-FDR ilungisiwe P = 0.006] (Itheyibhile 3⇓). Izifundo ezinqabileyo zazingenayo imixholo emhlophe emhlophe, xa kuthelekiswa nezifundo ezikhulupheleyo, kuwo nawuphi na umhlaba wengqondo. Ithetha ukuthini (sd) umthamo wemicimbi emhlophe yehlabathi ibingama-0.486 iilitha (0.063) kwizifundo ezirhabaxa kunye neelitha ze-0.458 (0.044) kwizifundo ezinobunkunkqele (ukulungiswa kwe-TIV P = 0.14).
A, Imimandla apho izifundo ezingamanyala zibonisa imixholo emhlophe emhlophe, xa kuthelekiswa nezifundo ezinqabileyo. Imephu zobume beparametric zenzelwe umyinge we-T1 MRI yesampulu yonke yokufunda (n = 46). Umbala webala ichaza amaxabiso ama-T. Qaphela ukuhanjiswa ngokulinganayo kwamaqela kwii-lobes zexeshana kunye nengqondo yobuchopho. Iziphumo eziphambili zivelisiwe, i-FDR ilungisiwe P = 0.006. B, Imicimbi emhlophe miqulu yabesilisa (izikwerekunye nemazi (izangqa) Izifundo kwiqela elineenxalenye ezithile zekhephu lesehlo lasekhohlo kunye ne-limbic lobes (i-16,228 voxels), emelwe njengomsebenzi wenqwanqwa lokuya kumjikelezo wolusu. Qaphela imiba emhlophe engezantsi kwizifundo ezinesinqe esisezantsi ukuya kumyinge wehip.
Iindawo ezinomahluko obalulekileyo ngommandla kwivolumu yomba omhlophe kwinxalenye 1 kunye nenxalenye II yophando
Uqhakamshelwano olwenziweyo lubonwe phakathi komthamo wezinto ezimhlophe kunye esinqeni somlinganiso weqela le -esex kwi-lobes yexeshana, isisu sobuchopho, kunye ne-cerebellum (njengoko ngasentla). Ukongeza, ukulungelelaniswa okufanayo kwabonwa kwiindawo ze-limbic kunye ne-occipital lobes (i-lens ye-lentiform kunye ne-occipital gyrus ephakathi). Ezi ndawo zenze amaqela amabini ngokudibana okukhulu [i-59,340 ii-voxels, i-voxel ephezulu (kwi-−33 mm, −53 mm, −47 mm), FDR ilungisiwe P = 0.008; I-voxels ze-7,269, i-voxel ephezulu (kwi-43 mm, −48 mm, −21 mm), i-FDR ilungisiwe P = 0.008]. Ubudala abuzange buxananaze kakhulu esinqeni kwisilinganiselo somvambo (r = 0.21, P = 0.28). Olunye unxulumano oluqinisekileyo kwizifundo ezi-feta zafunyanwa phakathi komthamo wezinto ezimhlophe kunye ne-serum free fat acid acid. Oku kwakubalulekile kwiqela elalihlala iinxalenye zeendawo zesobunxele zokwexeshana kunye neze-occipital (i-10,682 ii-voxels, i-voxel ephezulu (kwi-−43 mm, −49 mm, −18 mm), FDR isilungisiwe P = 0.004]. Akukho lungelelwaniso lubonakalayo phakathi komthamo wamacala amhlophe kunye ne-BMI. Kwiqela elixhasayo, akukho lungelelwaniso lubonakalayo phakathi kwamanyathelo omzimba okanye e-metabolic kunye nemithamo yommandla.
Kwakungekho mahluko mkhulu ngokwezibalo kwimiba embaxa engwevu phakathi kwezifundo ezi-tyebileyo nezomeleleyo, nangona izifundo ezinqabileyo zazinomgangatho wegreythi enkulu kwimimandla ethile yobuchopho njenge-gingri gyri, eyokuphamba kunye neyaphambi kwentloko yengqondo, isiqu sobuchopho, kunye ne-cerebellum ( I-FDR ilungisiwe P = 0.025). Ithetha ukuthini (sd) umthamo wemicimbi ye-grey yehlabathi yayiyi-0.752 yeelitha (0.070) kwizifundo ezikhulupheleyo kunye neelitha ze-0.734 (0.074) kwizifundo ezinobunkunkqele (ukulungiswa kwe-TIV P = 0.79).
Iziphumo zokutya (icandelo 2)
Iiveki ezintandathu zokutya okwenziwe nge-VLC zibangele ukunciphisa okunobunzima obukhulu kuzo zonke izifundo ezi-feta [i-11 (3.4) kg, ububanzi be-6.6-19 kg] kunye nokwehla kwesikali kunye nama-visceral fat mass endaweni yesisu (Itheyibhile 2⇓). Ukuthoba umzimba kunxulunyaniswa nokwehla koxinzelelo lwegazi, cholesterol, leptin, kunye ne-glycosylated hemoglobin (Itheyibhile 2⇓), kodwa akukho lutshintsho lubonakalayo ekuboneni ngokukhawuleza kwe-glucose ye-plasma kunye noxinzelelo lwe-insulin.
Isiphumo sokutya kwimilinganiselo yomzimba kunye nexabiso laselebhu (emva kokuzila)
Ukutya ngokudibeneyo kuncitshisiwe ivolumu emhlophe yehlabathi: Iilitha ze-0.498 (0.051) ngaphambili kunye neelitha ze-0.488 (0.048) emva kokutya (P = 0.002). Umba omhlophe womda unciphile kwi-lobe yetempeli yasekhohlo (fusiform gyrus; parahippocampal gyrus; kwaye isezantsi, medial, kunye ne-gyri yokwexeshana) [I-12,026 i-voxels contiguous, i-voxel ephezulu (kwi-−46, −6, kunye ne-−31 mm), ukulungiswa kwe-FDR P = 0.009] (Fig. 2⇓, A no-B, kunye neTheyibhile 3⇑). Ukongeza, ukunciphisa umbandela omhlophe kufikelele kwinqanaba lokubaluleka kwinqanaba elinye namanye amaqela (ukulungiswa kwe-FDR) P ixabiso phakathi kwe0.03 kunye ne0.07). Akukho nasinye sezakhi zobuchopho ezibonise ukwanda kwimiba emhlophe emhlophe emva kokutya. Iinguqu kwimiba yehlabathi okanye yengingqi engwevu ibingabalulekanga (P > 0.28).
A, Ingingqi yeBrain apho izifundo ezingamanyala zibonakalise ukunciphisa okubonakalayo kwimiba emhlophe emhlophe emva kwe6 wk yokutya. Imephu zobume beparametric ziyilelwe kwi-T1 MRI ye-subsidy yokutya (n = 16). Umbala webala Ixabiso le-T amanani, i-FDR elungisiwe P = 0.009. B, Iziphumo zokutya kwimicimbi emhlophe nganye kwiqela eliboniswe ku-A. Izikwere, Izifundo ezingamadoda; izangqa, izifundo zesetyhini.
ingxoxo
Olu phononongo lubonisa ukuba izifundo ezikhulupheleyo zinemiba emhlophe emhlophe kwiingingqi ezisisiseko zobuchopho, xa kuthelekiswa nezifundo ezinqabileyo. Xa izifundo ze-feta zanyangwa nge-VLCD ye-6 wk, ukuncitshiswa komthamo wemicimbi emhlophe yehlabathi kunye nomthamo wemicimbi emhlophe yengingqi kwi-lobe yetempile esekhohlo yafunyanwa. Iivolumu zelizwe ezingwevu nezengingqi zaye zafana phakathi kwamaqela kwaye azitshintshiwe ngokutya.
Ukunyusa umthamo wemicimbi emhlophe kutsha nje kufunyenwe kufutshane ne-striatum yezifundo ezi-fetaese (BMI 39.4) (12). Kolu phononongo, umthamo wemicimbi engwevu wawusezantsi kwizifundo ezikhuluphelayo kwimimandla eliqela yobuchopho kwaye umanyano olungafaniyo lwabonwa phakathi kwe-BMI kunye nomthamo wento engwevu kumbala oshiyekileyo we-gormus kwizifundo ezi-kodwa ezingezizo. Asifumenanga umahluko obonakalayo ongwevu phakathi kwezifundo ezinqabileyo kunye nezidumbileyo, nangona bekukho iindawo ezithile zobuchopho apho izifundo ezingamanyala zibonisa inqanaba lomgangatho wempunga lomgangatho ongaphantsi komntu onqabileyo (P = 0.025). Kuba izifundo ezikhoyo kwisifundo esikhoyo zazimbadlile, xa kuthelekiswa nezo zangaphambili.12), kunokwenzeka ukuba ukukhuluphala kakhulu okungapheliyo okuchaphazela umba ompu kunye nomcimbi omhlophe.
Kolu phando lukhoyo, imiba emhlophe emikhulu kwiqela le-feta ibonwa kwimimandla esisiseko yamacala, kwaye ulwandiso lwemicimbi emhlophe lwalunxulunyaniswa nokunyuka kwesinqe kumlinganiso we-hip (ukulungiswa kwesini) kodwa hayi iBMI. Izifundo ezininzi zibonakalise ukuba ukuhanjiswa, kunokuba kuninzi, kwamafutha omzimba kunxulumene notshintsho lwe-metabolic (20, 21, 22). Ukujonga umlinganiso we-hip ubonakala ungcono kune-BMI ekuvavanyeni umngcipheko wezifo zentliziyo kunye nokuchaphazeleka kwimetaboliki kumabhinqa angaphambi kunye nabe-postmenopausal (23). Ukongeza, kukho ubungqina bophononongo olukhulu lwakutsha nje (n = 27,007), ukuba isinqe somlinganiso we-hip songeza ulwazi lwe-proology kumngcipheko wentliziyo nakwabasetyhini kuwo onke amanqanaba e-BMI kunye namadoda anesisindo esiqhelekileyo (24). Kwisifundo esikhoyo, sibone ulwalamano oluluqilima lwesini oluchanekileyo phakathi kwesinqe ukuya kumyinge we-hip kunye nevolumu emhlophe yemicimbi. Oku kuphakamisa ukuba umba omhlophe we-cypbral unokuba unxulumene kakhulu nokuqokelelwa kwamafutha asesiswini kunokuba amanqatha omzimba ngomntu ngamnye. Ngaphakathi kwingqondo, nangona kunjalo, ubukhulu bebonke bamaqela abonisa ukuba ubudlelwane bungangaphezulu ngokubanzi kwaye bungaphantsi komda othile. Olunye utoliko lunokuthi ukunyuka kwamafutha e-visceral kunxulunyaniswa nokuqokelelwa kwamafutha kumbindi we-myelin kwingqondo iphela.
Uphononongo lwangoku lubonakalise unxulumano olungileyo phakathi kwe-serum yamafutha acid egreyidi kunye nomthamo omhlophe wobuchopho kumanqanaba asekho okwethutyana kunye ne-occipital lobes kwizifundo ezi-feta, kunye nezifundo ezikhulupheleyo zibonakalise ukugxila okukhulu kwe-serum yamafutha asimahla. Ke ngoko, inkcazo yemeko emhlophe engafaniyo nokukhuluphala inokuba yinto engaqhelekanga yomzimba kunye nokuqokelelwa kwengqondo. Izifundo zangaphambili kunye neentonga zibonise ukuba i-hypothalamic metabolism ye-fatty acids inokutshintsha indlela yokondla kwaye amanqanaba e-hypothalamic amanqatha amancinci-chain acyltransferase-coenzyme A inokunyuswa ngokuqiniswa okuqinisiweyo kokujikeleza okanye i-lipids ephakathi kunye / okanye ngokuvinjwa kwendawo ye i-lipid oxidation (25). Iziphumo zophando olukhoyo ngoku kunye neziphumo zezifundo zezilwanyana zibonisa ukuba ukutyeba ngokweqile kwe-acid ekutyeba kakhulu kunokubangela ukuqina kwemetabolism yengqondo kwingqondo, kwaye oku kunokuba negalelo kuyo yonke imiba emitsha yobuchopho kunye nomsebenzi wengqondo kulawulo lokutya. ukutya. Kwelinye icala, nangona ukwahluka kwevolumu kufunyenwe kungqinelana ne-hypothesis yophando, abaqinisekisi ngqo ukuba ukutyeba kuhamba kunye nokuqokelela kwamafutha kwingqondo. Ukuqinisekisa i-hypothesis, izifundo ezizayo kufuneka zinike ubungqina obungakumbi bokuba ubuchopho bamafutha asebusweni buye batshintsha emzimbeni.
Kufuneka kuqatshelwe ukuba i-VBM inokufumana ngokuchanekileyo utshintsho lwevolumu yengingqi, ayiboneleli nangayiphi na indlela malunga nearhente ye-causative. Ukunyuswa kwevolumu emhlophe kwimiba yokukhuluphala akukho mfuneko yokuba inxulumene ne-adipose tishu okanye i-myelin. Kwithiyori, ubume be-hydrate eyodwa bunokuba nefuthe kumthamo omhlophe kuba ukungabikho kwamanzi kwi-16 h kuye kwathiwa kuyehla umthamo wobuchopho nge0.55% (26). Nangona kunjalo, izifundo ezinqabileyo kunye nezidumbileyo zilandele imiyalelo efanayo yokuzila ngaphambi kokuvavanywa kwe-MRI kwaye yayinexabiso eliqhelekileyo (kunye nelifanayo) yegazi hematocrit (kuthetha ukuba i-41% kwiqela elinobunewunewu, i-42% kwiqela eli-leese. Okwesibini, iziphumo zifunyenwe ngokwengingqi kwaye zibekwe ikakhulu kwimimandla yobuchopho basal. Kwisigaba sokungenelela, Izifundo ezikhulupheleyo zanikwa ukutya kwe-1-wk standardocaloric yokutya ngaphambi kweskena se-MRI yesibini, ekwenza kube lula ukulingana kwamanzi. Babenamaxabiso aqhelekileyo e-hematocrit ngaphambi nasemva kokutya (39 vs. I-37%, ngokulandelelana), iphakamisa ukuba akukho zinguqu zibalulekileyo kwisimo se-hydration.
Ukuhambisa umzimba kuyaziwa ngokuphucula ukuziva kwe-insulin kunye neprofayili ye-plasma lipid (14), kungoko kuthintela i-comorbidities enxulumene nokukhuluphala. Iziphumo zokutya kwisimo seengqondo azifundiswanga ngaphambili. Umcimbi omhlophe ukwehla okubangelwa kukutya kwinxalenye yesibini yolu phando ngoku kunye neziphumo zenxalenye ndiyacebisa ukuba ukuzuza ubunzima obunganyangekiyo kunye nokuthoba umzimba ngokukhawuleza kunxulunyaniswa nengqondo emhlophe kwengqondo. Kwakungaphaya komgangatho kolu phando ukuphanda ngokubaluleka kweklinikhi yotshintsho lomthamo omhlophe ekutyeba kakhulu. Asinakho ukuphendula ukuba utshintsho olwenziweyo lobuchopho lusisiseko okanye sesibini. Nangona kunjalo, kwisiseko sobunini bezinto ezifunyenweyo kumcimbi omhlophe we-myelin (ngokulondolozwa kwezinto ezingwevu), sicinga ukuba utshintsho olubonakalisiweyo lusekwesibini, lubonisa ukuqokelela kwamafutha. Asiphumelelanga ukulungelelanisa utshintsho lomcimbi omhlophe kwindlela otya ngayo kwiinguqu kumanyathelo omzimba okanye e-metabolic, nangona ulwalamano lomgangatho phakathi kokuncitshiswa kwento emhlophe kunye nelahleko yesisu ye-visceral yamafutha (ngokubhekisele kumanqatha e-sc) yabonwa. Iziphumo azisebenzi, nangona kunjalo, zibonisa ukuba utshintsho kumbala omhlophe ngmcimbi ohlukileyo wokufumana ubunzima kunye nokwehla komzimba kodwa into yokuba iziqendu ezifundwayo ze-30 ze-esese (icandelo I) kunye nezifundo ze-obese ze-16 zinokuba zincinci kakhulu kuhlalutyo kuhlalutyo kunye umahluko omkhulu. Okokugqibela, ngenxa yeempazamo zobhaliso ezinokubakho kunye nokugudla, kucingeleka ukuba nangona uninzi lokwahlukana okubonakalayo kubonakalisa utshintsho lwemicimbi emhlophe, alunakukhutshelwa ngaphandle ukuba uphawu oluthile lwempunga lubandakanyiwe kwisiginali ewonke.
Ukuqukumbela, sinikezele ngedatha ebonisa ukuba ukutyeba okunxulunyaniswa nokwanda komthamo wobuchopho bemicimbi emhlophe. Olona lwalamano lubaluleke kakhulu lubonwe phakathi kwesinqe ukuya kumyinge we-hip kunye nomba omhlophe. Kuphononongo olude, iziphumo zibonise ubuchopho bemicimbi emhlophe emva kokwenza ixesha elifutshane lokutya. Nangona izifundo zodandatheko zibonisile ukuba umngcipheko wezifo zobuchopho obuthathaka uyonyuka kubantu abatyebileyo, ukubaluleka kweklinikhi kwalapha kuboniswe utshintsho olumhlophe kwimeko yokukhuluphala nokutya okutyayo kuhlala kungacacanga. Izifundo ezizayo zingenziwa ukuba zenze uphando ngendima yokuqokelelwa kwamafutha kumbindi kunye nokuchaphazeleka kwimiba emhlophe kwi-neuropathogenesis degeneration.
Imibulelo
Sibulela uGqr Paul Maguire (weYunivesithi yaseGroningen, eGroningen, eNetherlands) ngoncedo olukhulu ekuhlalutheni imifanekiso. Sibulela kakhulu abasebenzi beZiko le-PET laseTurku ngoncedo lwabo ngobuchule kwiimviwo.
Imihlathi
Lo msebenzi uxhaswe yiAkhademi yaseFinland (Isigqibo 104334), isibhedlele iTurku University Central Hospital, kunye neYunivesithi yaseTurku.
Ulwazi lokuCacisa: I-LTH, i-AV, i-RP, i-NK, i-JOR, i-PN, kunye ne-VK ayinanto yokuxela.
Ipapashwe kuqala kwi-Intanethi ngoMeyi 29, 2007
Izifinyezo: BMI, Isalathiso sobunzima bomzimba; I-FDR, inqanaba lokufumanisa okungamanga; I-fMRI, i-MRI esebenzayo; I-MRI, imaging ye-magnetic resonance; I-PET, i-positron emission tomography; I-TIV, umthamo opheleleyo we-intracranial; I-VBM, i-voxel-based morphometry; I-VLCD, ukutya okusezantsi kakhulu kwekhalori.
- I funyenwe Novemba 13, 2006.
- Zamkelwa Meyi 23, 2007.
;