White matter hyperintensities in middle-aged adults with childhood-onset type 1 diabetes
White matter hyperintensities in middle-aged adults with childhood-onset type 1 diabetes
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DOI：
10.1212/wnl.0000000000001582
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发表时间：
2015-05-19
期刊：
影响因子：
9.9
通讯作者：
Rosano, Caterina
中科院分区：
文献类型：
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作者：
Nunley, Karen A.;Ryan, Christopher M.;Rosano, Caterina
目的：虽然微血管并发症在1型糖尿病（T1 DM）中很常见，但很少有研究量化这些患者脑微血管损伤的严重程度，风险因素和影响。随着T1 DM患者预期寿命的增加，患者暴露于可能导致脑微血管疾病的年龄和疾病相关因素。方法：对97例儿童期起病的T1 DM中年患者的白色高信号（WMH）和梗死的严重程度和体积进行量化（平均年龄和病程：分别为50岁和41岁）和81例非T1 DM成人（平均年龄：48岁），同时进行认知和健康相关测量。与非T1 DM受试者相比，（Fazekas评分2和3与Fazekas评分1相比，p < 0.0001）和较慢的信息处理（数字符号替换，数字正确：65.7 +/- 10.9和54.9 +/- 13.6;钉板，秒：66.0 +/- 9.9和88.5 +/- 34.2;均p < 0.0001）与年龄、教育或其他因素无关。WMH与较慢的信息处理有关;调整WMH后，处理速度的组间差异减弱（数字符号为13%，钉板为11%，均为P
Objective: Although microvascular complications are common in type 1 diabetes mellitus (T1DM), few studies have quantified the severity, risk factors, and implications of cerebral microvascular damage in these patients. As life expectancy in patients with T1DM increases, patients are exposed to age-and disease-related factors that may contribute to cerebral microvascular disease.Methods: Severity and volume of white matter hyperintensities (WMH) and infarcts were quantified in 97 middle-aged patients with childhood-onset T1DM (mean age and duration: 50 and 41 years, respectively) and 81 non-T1DM adults (mean age: 48 years), concurrent with cognitive and health-related measures.Results: Compared with non-T1DM participants, patients had more severe WMH (Fazekas scores 2 and 3 compared with Fazekas score 1, p < 0.0001) and slower information processing (digit symbol substitution, number correct: 65.7 +/- 10.9 and 54.9 +/- 13.6; pegboard, seconds: 66.0 +/- 9.9 and 88.5 +/- 34.2; both p < 0.0001) independent of age, education, or other factors. WMH were associated with slower information processing; adjusting for WMH attenuated the group differences in processing speed (13% for digit symbol, 11% for pegboard, both p