The silent occurrence of cerebral small vessel disease in nonelderly patients with type 2 diabetes mellitus
The silent occurrence of cerebral small vessel disease in nonelderly patients with type 2 diabetes mellitus
复制标题
中年2型糖尿病患者脑小血管病变的悄然发生
DOI：
10.1111/1753-0407.13164
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发表时间：
2021-02-26
影响因子：
4.5
通讯作者：
Peng, Yongde
中科院分区：
文献类型：
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作者：
Fang, Fang;Cao, Rong;Peng, Yongde
老年2型糖尿病（T2 DM）患者脑小血管病（SVD）的患病率增加，加重认知功能下降。然而，无痴呆的非老年T2 DM患者中SVD的患病率和严重程度在很大程度上尚不清楚。我们的主要目的是调查SVD在这样的患者，特别关注SVD和糖尿病周围感觉运动性多发性神经病（DSP）之间的相关性。方法我们招募了180名青年和中年受试者没有认知功能障碍（106 T2 DM，74对照）。研究磁共振成像上脑SVD的体征，并通过综合评分评估总体SVD负担。T2 DM患者接受了进一步详细的DSP评估。结果T2 DM患者微出血发生率和瓣膜SVD的总负担均显著高于对照组（P < 0. 05）。此外，DSP的存在与糖尿病组调整后SVD风险增加有关。多伦多临床评分系统值与SVD评分增加呈正相关，双侧腓肠感觉神经传导速度与SVD评分增加呈负相关。结论目前的研究结果将SVD的患病率增加扩展到无痴呆的非老年T2 DM患者，提示T2 DM患者的认知筛查和预防时间可能会提前。特别是对于那些有DSP的人。
Background The prevalence of cerebral small vessel disease (SVD) increases in elderly patients with type 2 diabetes (T2DM), exacerbating cognitive decline. However, the prevalence and the severity of SVD in dementia-free nonelderly T2DM patients were largely unknown. Our primary aim is to investigate SVD in such patients, with a specific focus on the correlation between SVD and diabetic peripheral sensorimotor polyneuropathy (DSP).Methods We recruited 180 young and middle-aged subjects without cognitive impairment (106 with T2DM, 74 controls). Signs of cerebral SVD on magnetic resonance image were investigated, and the overall SVD burden was evaluated by a combined score. Patients with T2DM underwent further detailed DSP assessment. Regression models were used to investigate the association of SVD with the presence of T2DM, and the associations of the prevalence and severity of SVD and DSP were also explored in patients with T2DM.Results The prevalence of microbleeds and overall burden of SVD were significantly higher in T2DM patients than in the controls. Further, the presence of DSP related to an increased risk of SVD after adjustment in diabetic group. Moreover, Toronto Clinical Scoring System values were positively associated with the increased SVD scores, and bilateral sural sensory nerve conduction velocities were negatively associated with increasingly severity of SVD scores.Conclusion The current findings extended the increasing prevalence of SVD to dementia-free nonelderly patients with T2DM, suggesting that the time for cognitive screening and prevention might be moved forward in T2DM patients, especially for those with DSP.