Cerebral perfusion and aortic stiffness are independent predictors of white matter brain atrophy in type 1 diabetic patients assessed with magnetic resonance imaging.
Cerebral perfusion and aortic stiffness are independent predictors of white matter brain atrophy in type 1 diabetic patients assessed with magnetic resonance imaging.
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DOI：
10.2337/dc10-1446
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发表时间：
2011-02
期刊：
影响因子：
16.2
通讯作者：
de Roos A
中科院分区：
文献类型：
--
作者：
van Elderen SG;Brandts A;van der Grond J;Westenberg JJ;Kroft LJ;van Buchem MA;Smit JW;de Roos A
通过磁共振成像（MRI）研究脑体积与脑灌注和主动脉僵硬度之间的关系，确定1型糖尿病（DM）患者脑萎缩的血管机制。获得了当地机构审查委员会的批准，并且患者给予了知情同意。前瞻性入组了51例1型DM患者（30例男性;平均年龄44 ± 11岁;平均DM病程23 ± 12年）和34例年龄和性别匹配的健康对照受试者。排除标准包括高血压、中风、主动脉疾病和标准MRI禁忌症。使用MRI评估了白色物质（WM）和灰质（GM）脑容量、脑总血流量（tCBF）、脑总灌注和主动脉脉搏波速度（PWV）。采用多变量线性回归分析进行统计，协变量为年龄、性别、平均动脉压、BMI、吸烟、心率、DM病程和HbA 1c。与对照组相比，1型DM患者的WM和GM脑体积均减少（WM P = 0.04;各自GM P = 0.03）。与对照组相比，1型糖尿病患者的总脑灌注增加（β =-0.219，P < 0.05）。总CBF和主动脉PWV预测1型DM患者的WM脑体积（tCBF β = 0.352，P = 0.024;主动脉PWV β =-0.458，P = 0.016）。年龄是GM脑体积的独立预测因子（β =-0.695，P < 0.001）。无高血压的1型糖尿病患者与对照组相比，WM和GM体积减少，脑灌注相对增加。总CBF和主动脉僵硬度独立预测1型DM患者WM脑萎缩。只有年龄能预测GM脑萎缩。
To identify vascular mechanisms of brain atrophy in type 1 diabetes mellitus (DM) patients by investigating the relationship between brain volumes and cerebral perfusion and aortic stiffness using magnetic resonance imaging (MRI). Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA1c. Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = −0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = −0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = −0.695, P < 0.001). Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy.
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影响因子：
5.9
作者：
van Elderen SG;Brandts A;Westenberg JJ;van der Grond J;Tamsma JT;van Buchem MA;Romijn JA;Kroft LJ;Smit JW;de Roos A
通讯作者：
de Roos A
影响因子：
4.4
作者：
Grotenhuis, Heynric B.;Westenberg, Jos M.;de Roos, Albert
通讯作者：
de Roos, Albert
影响因子：
16.2
作者：
Kozera, Grzegorz M.;Wolnik, Bogumil;Bieniaszewski, Leszek
通讯作者：
Bieniaszewski, Leszek
影响因子：
7.7
作者：
Musen, G;Lyoo, IK;Jacobson, AM
通讯作者：
Jacobson, AM
影响因子：
8.3
作者：
Longstreth, WT;Manolio, TA;Fried, L
通讯作者：
Fried, L