Cerebral white matter and retinal arterial health in hypertension and type 2 diabetes mellitus.
Cerebral white matter and retinal arterial health in hypertension and type 2 diabetes mellitus.
复制标题
高血压和2型糖尿病的脑白质和视网膜动脉健康。
DOI：
10.1155/2013/329602
复制
发表时间：
2013
影响因子：
1.9
通讯作者：
Convit A
中科院分区：
文献类型：
--
作者：
Yau PL;Hempel R;Tirsi A;Convit A
我们检查了33名高血压(22名合并2型糖尿病(T2 DM))和29名血压正常(8名T2 DM)中老年成年人，年龄和教育程度相当。与血压正常的受试者相比，高血压患者，除了脑室周围白质(WM)损害的发生率较高外，MRI扩散张量成像显示，主要纤维束的WM微结构完整性显著降低。在高血压患者中，合并T2 DM的患者(n=22)比未合并T2 DM的患者(n=11)有更广泛的西医病变。此外，与先前的研究一致，高血压和T2 DM都与视网膜动脉内径减小有关。进一步的探索性分析表明，在高血压患者中观察到的视网膜小动脉狭窄与广泛的亚临床西医微结构完整性丧失有关，并且这些关联主要出现在额叶。我们发现，T2 DM增加了高血压对大脑WM的损害作用，值得注意的是，这些影响与年龄和体重指数无关。鉴于视网膜小动脉直径的减小可能是脑小动脉平行病理的生物标志物，我们的数据表明，在存在高血压和T2 DM的情况下，额叶可能特别容易受到微血管的损害。
We examined 33 hypertensive (22 with comorbid type 2 diabetes mellitus (T2DM)) and 29 normotensive (8 with T2DM) middle-aged and elderly adults, comparable in age and education. Relative to normotensive participants, those with hypertension, in addition to a higher prevalence of periventricular white matter (WM) lesions, had significantly lower WM microstructural integrity of major fiber tracts as seen with MRI-based diffusion tensor imaging. Among participants with hypertension, those with co-morbid T2DM (n = 22) had more widespread WM pathology than those without T2DM (n = 11). Furthermore and consistent with previous research, both hypertension and T2DM were related to decreased retinal arterial diameter. Further exploratory analysis demonstrated that the observed retinal arteriolar narrowing among individual with hypertension was associated with widespread subclinical losses in WM microstructural integrity and these associations were present predominantly in the frontal lobe. We found that T2DM adds to the damaging effects of hypertension on cerebral WM, and notably these effects were independent of age and body mass index. Given that the decrease in retinal arteriolar diameter may be a biomarker for parallel pathology in cerebral arterioles, our data suggest that the frontal lobe may be particularly vulnerable to microvascular damage in the presence of hypertension and T2DM.