Diabetes increases atrophy and vascular lesions on brain MRI in patients with symptomatic arterial disease
Diabetes increases atrophy and vascular lesions on brain MRI in patients with symptomatic arterial disease
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DOI：
10.1161/strokeaha.107.506089
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发表时间：
2008-05-01
期刊：
影响因子：
8.3
通讯作者：
Mali, Willem P. T. M.
中科院分区：
文献类型：
--
作者：
Tiehuis, Audrey M.;Van der Graaf, Yolanda;Mali, Willem P. T. M.
背景和目的：2型糖尿病（DM 2）与认知能力加速下降和脑结构异常有关。大血管疾病已被描述为DM2.Methods-脑MRI的参与其他DM 2相关factors.Methods -脑MRI的变化的一个决定因素进行了1043参与者（151 DM 2）有症状的动脉疾病。脑体积通过自动分割获得。结果-动脉疾病和DM 2患者有更多的全球和皮质下脑萎缩（-1.20%脑/颅内体积[95% CI -1.58至-0.82]，P < 0.0005和0.20%脑室/颅内体积[0.05至0.34]，P < 0.01），与无DM的相同患者相比，WMH体积更大（0.22对数转换体积[0.07至0.38]，P < 0.005），腔隙性梗死更多（OR 1.75 [1.13至2.69]，P < 0.01）2。在DM 2患者中，高血糖水平（B - 0.12%/mmol/L [-0.23至-0.01]，P < 0.05）和糖尿病病程（B - 0.05%/年[-0.10至-0.001]，P < 0.05）与全脑萎缩相关。DM 2对大脑有额外的有害影响。在DM 2患者中，高血糖和糖尿病持续时间有助于脑萎缩。
Background and Purpose - Diabetes type 2 (DM2) is associated with accelerated cognitive decline and structural brain abnormalities. Macrovascular disease has been described as a determinant for brain MRI changes in DM2, but little is known about the involvement of other DM2-related factors.Methods - Brain MRI was performed in 1043 participants (151 DM2) with symptomatic arterial disease. Brain volumes were obtained through automated segmentation.Results - Patients with arterial disease and DM2 had more global and subcortical brain atrophy (-1.20% brain/intracranial volume [95% CI -1.58 to - 0.82], P < 0.0005 and 0.20% ventricular/intracranial volume [0.05 to 0.34], P < 0.01), larger WMH volumes (0.22 logtransformed volume [0.07 to 0.38], P < 0.005), and more lacunar infarcts (OR 1.75 [1.13 to 2.69], P < 0.01) than identical patients without DM2. In patients with DM2, high glucose levels (B - 0.12% per mmol/L [-0.23 to -0.01], P < 0.05) and diabetes duration (B - 0.05% per year [-0.10 to -0.001], P < 0.05) were associated with global brain atrophy.Conclusion - In patients with symptomatic arterial disease, DM2 has an added detrimental effect on the brain. In patients with DM2, hyperglycemia and diabetes duration contribute to brain atrophy.