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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Association between red blood cell count and cortical functional connectivity in type 2 diabetes mellitus patients residing at high altitude: resting-state fMRI study in the Tibetan Plateau

  • Jinli Meng1,2,3
  • Yingxue Gao1,2
  • Hailong Li1,2
  • Li Feng3
  • Xiangwei Li3
  • Zan Zhou3
  • Xin Hu3
  • Hengyan Li3
  • Yuanyuan He3
  • Yongyue Guo3
  • Xiaoyan Luo3
  • Wanlin He3
2 more authors
  • Yunhong Wu4
  • Xiaoqi Huang1,2,5
5 affiliations
  1. 1Department of Radiology, Huaxi MR Research Center (HMRRC), Institute of Radiology and Medical Imaging. West China Hospital of Sichuan University
  2. 2Psychoradiology Key Laboratory of Sichuan Province, West China Hospital of Sichuan University
  3. 3Department of Radiology, Hospital of Chengdu Office of The People’s Government of Xizang Autonomous Region
  4. 4Department of Endocrinology and Metabolism, Hospital of Chengdu Office of The People’s Government of Xizang Autonomous Region
  5. 5Xiamen Key Lab of Psychoradiology and Neuromodulation, Department of Radiology, West China Xiamen Hospital of Sichuan University
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Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction and emotional disturbances, in which the hippocampus and amygdala are key limbic structures. We investigated hippocampal and amygdala functional connectivity (FC) in Tibetan patients with T2DM residing in a high-altitude hypoxic environment and examined associations with clinical and biochemical measures.

Methods: We included 87 Tibetan patients with T2DM and 63 healthy controls (HC) from the Tibetan Plateau. Seed-based resting-state FC analysis was used to compare whole-brain hippocampal and amygdala FC between groups. Associations between altered FC and biochemical indices, emotional symptoms, and cognitive performance were assessed using Pearson or Spearman correlation analyses.

Results: Compared with HC, Tibetan patients with T2DM showed increased FC between the right hippocampus and the left dorsolateral prefrontal cortex (DLPFC)/superior frontal gyrus and between the left amygdala and the right orbitofrontal cortex (OFC)/right DLPFC. Within the T2DM group, hippocampal FC was positively associated with red blood cell (RBC) count and visuospatial memory scores, whereas amygdala FC was positively associated with visuospatial memory scores and Mini-Mental State Examination scores.

Conclusion: Tibetan patients with T2DM showed increased hippocampal and amygdala FC, which was associated with RBC count and memory-related cognitive performance. No significant associations were observed between altered FC and blood glucose measures. These findings characterize limbic-prefrontal connectivity alterations and their clinical associations in this high-altitude Tibetan T2DM cohort.

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Cite

BibTeXRIS
BibTeX
@article{meng2026association,
  title = {{Association between red blood cell count and cortical functional connectivity in type 2 diabetes mellitus patients residing at high altitude: resting-state fMRI study in the Tibetan Plateau}},
  author = {Jinli Meng and Yingxue Gao and Hailong Li and Li Feng and Xiangwei Li and Zan Zhou and Xin Hu and Hengyan Li and Yuanyuan He and Yongyue Guo and Xiaoyan Luo and Wanlin He and Yunhong Wu and Xiaoqi Huang},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1931880},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1931880/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association between red blood cell count and cortical functional connectivity in type 2 diabetes mellitus patients residing at high altitude: resting-state fMRI study in the Tibetan Plateau
AU  - Jinli Meng
AU  - Yingxue Gao
AU  - Hailong Li
AU  - Li Feng
AU  - Xiangwei Li
AU  - Zan Zhou
AU  - Xin Hu
AU  - Hengyan Li
AU  - Yuanyuan He
AU  - Yongyue Guo
AU  - Xiaoyan Luo
AU  - Wanlin He
AU  - Yunhong Wu
AU  - Xiaoqi Huang
PY  - 2026
DA  - 2026/10/14
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1931880
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1931880/full
AB  - Background: Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction and emotional disturbances, in which the hippocampus and amygdala are key limbic structures. We investigated hippocampal and amygdala functional connectivity (FC) in Tibetan patients with T2DM residing in a high-altitude hypoxic environment and examined associations with clinical and biochemical measures.  Methods: We included 87 Tibetan patients with T2DM and 63 healthy controls (HC) from the Tibetan Plateau. Seed-based resting-state FC analysis was used to compare whole-brain hippocampal and amygdala FC between groups. Associations between altered FC and biochemical indices, emotional symptoms, and cognitive performance were assessed using Pearson or Spearman correlation analyses.  Results: Compared with HC, Tibetan patients with T2DM showed increased FC between the right hippocampus and the left dorsolateral prefrontal cortex (DLPFC)/superior frontal gyrus and between the left amygdala and the right orbitofrontal cortex (OFC)/right DLPFC. Within the T2DM group, hippocampal FC was positively associated with red blood cell (RBC) count and visuospatial memory scores, whereas amygdala FC was positively associated with visuospatial memory scores and Mini-Mental State Examination scores.  Conclusion: Tibetan patients with T2DM showed increased hippocampal and amygdala FC, which was associated with RBC count and memory-related cognitive performance. No significant associations were observed between altered FC and blood glucose measures. These findings characterize limbic-prefrontal connectivity alterations and their clinical associations in this high-altitude Tibetan T2DM cohort.
SN  - 1664-2392
ER  -