Subclinical albuminuria is linked to gray matter atrophy in type 2 diabetes mellitus.
Subclinical albuminuria is linked to gray matter atrophy in type 2 diabetes mellitus.
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DOI：
10.1016/j.metabol.2014.07.008
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发表时间：
2014-11
影响因子：
9.8
通讯作者：
Novak, Vera
中科院分区：
文献类型：
--
作者：
Mehta, Disha;Pimentel, Daniela A.;Nunez, Maria-Zunilda;Abduljalil, Amir;Novak, Vera
微量白蛋白尿（MA）是肾脏微血管疾病的标志物，与老年2型糖尿病（DM）患者的脑萎缩和神经血管变化相关。我们评估了尿白蛋白与肌酐比值（UACR）和局部脑体积之间的关系，以确定亚临床白蛋白尿是否可能提示2型糖尿病的早期脑结构改变。我们研究了85例2型糖尿病患者（64.8 ± 8.3岁）和40名年龄匹配的对照者的UACR和脑体积，使用3D磁化准备梯度回波（MP-MRI）MRI（磁共振成像）在3特斯拉下快速采集。采用最小二乘法模型分析UACR与脑体积的关系。在DM患者中，UACR ≥ 5 mg/g，UACR ≥ 10 mg/g和临床显著MA（UACR ≥ 17 mg/g [男性]和25 mg/g [女性]）与额叶灰质（GM）体积降低相关（r2 adj = 0.2-0.4，P= 0.01-0.05）和UACR ≥ 5 mg/g也与GM总体萎缩相关（r2 adj= 0.1，P= 0.04），与DM病程、血糖水平、HbA 1c和高血压无关。对于UACR ≥ 5 mg/g，DM组中较低的总体GM体积与较差的执行功能相关（P= 0.04）。未发现UACR（< 5 mg/g）和对照组之间存在相关性。亚临床白蛋白尿（UACR ≥ 5 mg/g）与较低的GM体积相关，对老年糖尿病患者的认知功能具有临床影响，这些关系与DM控制和高血压无关。因此，UACR水平可以作为DM相关脑结构变化的额外标志物。
Microalbuminuria (MA), a marker of renal microvascular disease, is associated with brain atrophy and neurovascular changes in older adults with type 2 diabetes mellitus (DM). We evaluated the relationship between urine albumin-to-creatinine ratio (UACR) and regional brain volumes determine whether subclinical albuminuria may indicate early structural brain changes in type 2 DM. We studied UACR and brain volumes in 85 type 2 DM patients (64.8 ± 8.3 years) and 40 age-matched controls using 3D magnetization prepared rapid acquisition with gradient echo (MP-RAGE) MRI (magnetic resonance imaging) at 3 Tesla. The relationship between UACR and brain volumes was analyzed using the least square models. In DM patients, UACR ≥ 5 mg/g, UACR ≥ 10 mg/g and clinically significant MA (UACR ≥ 17 mg/g [males] and 25 mg/g [females]) were associated with lower gray matter (GM) volume in the frontal lobe (r2 adj = 0.2-0.4, P= 0.01-0.05) and UACR ≥ 5mg/g was also related to global GM atrophy (r2 adj= 0.1, P= 0.04), independent of DM duration, glucose levels, HbA1c and hypertension. For UACR ≥ 5mg/g, a lower global GM volume was related to worse executive function (P= 0.04) in the DM group. No associations were found for UACR (< 5 mg/g) and controls. Subclinical albuminuria (UACR ≥ 5 mg/g) is associated with lower GM volume that has clinical impact on cognitive function in older diabetic patients, and these relationships are independent of DM control and hypertension. Therefore, UACR levels may serve as an additional marker of DM-related brain structural changes.
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影响因子：
4.4
作者：
Knopman, David S.;Mosley, Thomas H., Jr.;Turner, Stephen T.
通讯作者：
Turner, Stephen T.
影响因子：
16.2
作者：
de Bresser J;Tiehuis AM;van den Berg E;Reijmer YD;Jongen C;Kappelle LJ;Mali WP;Viergever MA;Biessels GJ;Utrecht Diabetic Encephalopathy Study Group
通讯作者：
Utrecht Diabetic Encephalopathy Study Group
影响因子：
8.2
作者：
Manschot, S. M.;Biessels, G. J.;de Valk, H.;Algra, A.;Rutten, G. E. H. M.;van der Grond, J.;Kappelle, L. J.
通讯作者：
Kappelle, L. J.
影响因子：
168.9
作者：
Matsushita, Kunihiro;van der Velde, Marije;Astor, Brad C.;Woodward, Mark;Levey, Andrew S.;de Jong, Paul E.;Coresh, Josef;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
--
作者：
Bartzokis, G;Beckson, M;Mintz, J
通讯作者：
Mintz, J