Abstract

Diabetic encephalopathy (DE) is a diabetic complication characterized by alterations in cognitive function and nervous system structure. The pathogenic transition from hyperglycemia to DE is a long-term process accompanied by multiple metabolic disorders. Exploring time-dependent metabolic changes in hippocampus will facilitate our understanding of the pathogenesis of DE. In the present study, we first performed behavioral and histopathological experiments to confirm the appearance of DE in rats with streptozotocin-induced diabetes. We then utilized nuclear magnetic resonance-based metabonomics to analyze metabolic disorders in the hippocampus at different stages of DE. After 1 week, we observed no cognitive or structural impairments in diabetic rats, although some metabolic changes were observed in local hippocampal extracts. At 5 weeks, while cognitive function was still normal, we then examined initial levels of neuronal apoptosis. The characteristic metabolic changes of this stage included elevated levels of energy metabolites (i.e., ATP, ADP, AMP, and creatine phosphate/creatine). At 9 weeks, significant cognitive decline and histopathological brain damage were observed, in conjunction with reduced levels of some amino acids. Thus, this stage was classified as the DE period. Our findings indicated that the pathogenesis of DE is associated with time-dependent alterations in metabolic features in hippocampal regions, such as glycolysis, osmoregulation, energy metabolism, choline metabolism, branched-chain amino acid metabolism, and the glutamate–glutamine cycle. Furthermore, we observed alterations in levels of lactate and its receptor in hippocampal cells, which may be involved in the pathogenesis of DE.

Highlights

  • Diabetes mellitus is a common metabolic disorder that can lead to cognitive decline and dementia. Dejong (1950) introduced the term “diabetic encephalopathy (DE)” to describe cognitive impairment in diabetes

  • Using nuclear magnetic resonance (NMR)-based metabonomics, we demonstrated that Diabetic encephalopathy (DE) is associated with changes in glucose metabolism and disturbances in the glutamate–glutamine cycle in the hippocampus (Zheng Y. et al, 2016)

  • Our results indicated that diabetic rats exhibited learning and memory impairments

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Summary

Introduction

Diabetes mellitus is a common metabolic disorder that can lead to cognitive decline and dementia. Dejong (1950) introduced the term “diabetic encephalopathy (DE)” to describe cognitive impairment in diabetes. Diabetes mellitus is a common metabolic disorder that can lead to cognitive decline and dementia. Recent clinical studies have indicated that patients with diabetes exhibit slight structural changes in the cortical gray matter or other domains (Brismar et al, 2007; Jongen and Biessels, 2008). Diabetes-related cognitive decline is related to disrupted insulin signaling, oxidative stress, and mitochondrial dysfunction (Ye et al, 2011; Yi et al, 2011). These factors are critical in the development of cognitive impairment in the patients with diabetes. The detection of endogenous metabolic variations during the whole diabetic period may aid in elucidating the mechanisms involved in the pathogenesis of DE (Williams et al, 2005)

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