Jordi Sanahuja1, Núria Alonso2, Javier Diez3, Emilio Ortega4, Esther Rubinat5, Alícia Traveset6, Núria Alcubierre5, Àngels Betriu7, Esmeralda Castelblanco8, Marta Hernández9, Francisco Purroy1, Maria Vittoria Arcidiacono7, Carmen Jurjo6, Elvira Fernández10, Manuel Puig-Domingo2, Per-Henrik Groop11, Dídac Mauricio12. 1. Department of Neurology, University Hospital Arnau de Vilanova, Lleida, Spain. 2. Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and University Hospital, Badalona, Spain CIBERDEM, Instituto de Salud Carlos III (ISCIII), Madrid, Spain. 3. Institut de Diagnòstic per la Imatge, University Hospital Arnau de Vilanova, Lleida, Spain. 4. Institut de Recerca Biomedica de Lleida, University of Lleida, Lleida, Spain. 5. Department of Endocrinology & Nutrition, Institut d'Investigacions Biomediques August Pi Suñer, Centro de Investigación Biomédica en Red de la Obesidad y la Nutrición, Hospital Clinic, Barcelona, Spain. 6. Department of Ophthalmology, University Hospital Arnau de Vilanova, Lleida, Spain. 7. Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, University Hospital Arnau de Vilanova, Lleida, Spain. 8. Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and University Hospital, Badalona, Spain. 9. Department of Endocrinology and Nutrition, University Hospital Arnau de Vilanova, Lleida, Spain. 10. Department of Endocrinology & Nutrition, Institut d'Investigacions Biomediques August Pi Suñer, Centro de Investigación Biomédica en Red de la Obesidad y la Nutrición, Hospital Clinic, Barcelona, Spain Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, University Hospital Arnau de Vilanova, Lleida, Spain Department of Nephrology, University Hospital Arnau de Vilanova, Lleida, Spain. 11. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; and Baker IDI Heart and Diabetes Institute, Melbourne, Australia. 12. Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and University Hospital, Badalona, Spain CIBERDEM, Instituto de Salud Carlos III (ISCIII), Madrid, Spain didacmauricio@gmail.com.
Abstract
OBJECTIVE: We sought to examine the presence and severity of brain small vessel disease (SVD) in patients with type 2 diabetes and diabetic retinopathy (DR) compared with those without DR. RESEARCH DESIGN AND METHODS: We evaluated 312 patients with type 2 diabetes without previous cardiovascular disease (men 51%; mean age 57 years; age range 40-75 years); 153 patients (49%) had DR. MRI was performed to evaluate the presence and severity (age-related white matter changes scale) of white matter lesions (WMLs) and lacunes, and transcranial Doppler ultrasound was used to measure the Gosling pulsatility index (PI) of the middle cerebral artery (MCA). RESULTS: The prevalence of lesions of cerebral SVD (WML and/or lacunes) was higher in patients with DR (40.2% vs. 30.1% without DR, P = 0.04). Age (P < 0.01) and systolic blood pressure (P = 0.02) were associated with the presence of SVD. The severity of SVD was associated with age and the presence of DR (P < 0.01 and P = 0.01, respectively). Patients with DR showed a higher MCA PI compared with those without DR (P < 0.01). Age, systolic and diastolic blood pressure, and retinopathy and its severity were associated with an increased MCA PI (P < 0.01 for all variables). A positive correlation was found between MCA PI values and the presence and severity of SVD (P < 0.01 for both variables). CONCLUSIONS: Patients with type 2 diabetes who have DR have an increased burden of cerebral SVD compared with those without DR. Our findings suggest that the brain is a target organ for microangiopathy, similar to other classic target organs, like the retina.
OBJECTIVE: We sought to examine the presence and severity of brain small vessel disease (SVD) in patients with type 2 diabetes and diabetic retinopathy (DR) compared with those without DR. RESEARCH DESIGN AND METHODS: We evaluated 312 patients with type 2 diabetes without previous cardiovascular disease (men 51%; mean age 57 years; age range 40-75 years); 153 patients (49%) had DR. MRI was performed to evaluate the presence and severity (age-related white matter changes scale) of white matter lesions (WMLs) and lacunes, and transcranial Doppler ultrasound was used to measure the Gosling pulsatility index (PI) of the middle cerebral artery (MCA). RESULTS: The prevalence of lesions of cerebral SVD (WML and/or lacunes) was higher in patients with DR (40.2% vs. 30.1% without DR, P = 0.04). Age (P < 0.01) and systolic blood pressure (P = 0.02) were associated with the presence of SVD. The severity of SVD was associated with age and the presence of DR (P < 0.01 and P = 0.01, respectively). Patients with DR showed a higher MCA PI compared with those without DR (P < 0.01). Age, systolic and diastolic blood pressure, and retinopathy and its severity were associated with an increased MCA PI (P < 0.01 for all variables). A positive correlation was found between MCA PI values and the presence and severity of SVD (P < 0.01 for both variables). CONCLUSIONS:Patients with type 2 diabetes who have DR have an increased burden of cerebral SVD compared with those without DR. Our findings suggest that the brain is a target organ for microangiopathy, similar to other classic target organs, like the retina.
Authors: Liora G Rodill; Lieza G Exalto; Paola Gilsanz; Geert Jan Biessels; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimer Dis Assoc Disord Date: 2018 Apr-Jun Impact factor: 2.703
Authors: Yu-Hang Zhang; Wei Guo; Tao Zeng; ShiQi Zhang; Lei Chen; Margarita Gamarra; Romany F Mansour; José Escorcia-Gutierrez; Tao Huang; Yu-Dong Cai Journal: Front Microbiol Date: 2021-07-09 Impact factor: 5.640