Cerebral Perfusion and Aortic Stiffness Are Independent Predictors of White Matter Brain Atrophy in Type 1 Diabetic Patients Assessed With Magnetic Resonance Imaging
OBJECTIVE: To identify vascular mechanisms of brain atrophy in type 1 diabetes mellitus (DM) patients by investigating the relationship between brain volumes and cerebral perfusion and aortic stiffness using magnetic resonance imaging (MRI). RESEARCH DESIGN AND METHODS: Approval from the local insti...
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| Veröffentlicht in: | Diabetes care 2011-02, Vol.34 (2), p.459-463 |
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| creator | van Elderen, Saskia G.C Brandts, Anne van der Grond, Jeroen Westenberg, Jos J.M Kroft, Lucia J.M van Buchem, Mark A Smit, Johannes W.A de Roos, Albert |
| description | OBJECTIVE: To identify vascular mechanisms of brain atrophy in type 1 diabetes mellitus (DM) patients by investigating the relationship between brain volumes and cerebral perfusion and aortic stiffness using magnetic resonance imaging (MRI). RESEARCH DESIGN AND METHODS: Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA₁c. RESULTS: Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = -0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = -0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = -0.695, P < 0.001). CONCLUSIONS: Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy. |
| doi_str_mv | 10.2337/dc10-1446 |
| format | Article |
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RESEARCH DESIGN AND METHODS: Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA₁c. RESULTS: Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = -0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = -0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = -0.695, P < 0.001). CONCLUSIONS: Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc10-1446</identifier><identifier>PMID: 21216862</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Aortic Diseases - pathology ; Atrophy ; Biological and medical sciences ; Brain ; Brain Diseases - pathology ; Brain Diseases - physiopathology ; Care and treatment ; Cerebrovascular Circulation - physiology ; Diabetes ; Diabetes Mellitus, Type 1 - pathology ; Diabetes. Impaired glucose tolerance ; Diabetic Angiopathies - pathology ; Diabetic Angiopathies - physiopathology ; Diabetics ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Heart rate ; Humans ; Hypertension ; Leukoencephalopathies - pathology ; Leukoencephalopathies - physiopathology ; Magnetic Resonance Imaging ; Male ; Medical research ; Medical sciences ; Medicine, Experimental ; Metabolic diseases ; Middle Aged ; Miscellaneous ; Original Research ; Predictive Value of Tests ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Severity of Illness Index ; Software packages ; Studies ; Type 1 diabetes ; Veins & arteries</subject><ispartof>Diabetes care, 2011-02, Vol.34 (2), p.459-463</ispartof><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 American Diabetes Association</rights><rights>Copyright American Diabetes Association Feb 2011</rights><rights>2011 by the American Diabetes Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-c344f79cf543b00291e76498c3bb88f4ffadf37531888a3796d6e1b5a5429fad3</citedby><cites>FETCH-LOGICAL-c560t-c344f79cf543b00291e76498c3bb88f4ffadf37531888a3796d6e1b5a5429fad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23842111$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21216862$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Elderen, Saskia G.C</creatorcontrib><creatorcontrib>Brandts, Anne</creatorcontrib><creatorcontrib>van der Grond, Jeroen</creatorcontrib><creatorcontrib>Westenberg, Jos J.M</creatorcontrib><creatorcontrib>Kroft, Lucia J.M</creatorcontrib><creatorcontrib>van Buchem, Mark A</creatorcontrib><creatorcontrib>Smit, Johannes W.A</creatorcontrib><creatorcontrib>de Roos, Albert</creatorcontrib><title>Cerebral Perfusion and Aortic Stiffness Are Independent Predictors of White Matter Brain Atrophy in Type 1 Diabetic Patients Assessed With Magnetic Resonance Imaging</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE: To identify vascular mechanisms of brain atrophy in type 1 diabetes mellitus (DM) patients by investigating the relationship between brain volumes and cerebral perfusion and aortic stiffness using magnetic resonance imaging (MRI). RESEARCH DESIGN AND METHODS: Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA₁c. RESULTS: Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = -0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = -0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = -0.695, P < 0.001). CONCLUSIONS: Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy.</description><subject>Adult</subject><subject>Aortic Diseases - pathology</subject><subject>Atrophy</subject><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Brain Diseases - pathology</subject><subject>Brain Diseases - physiopathology</subject><subject>Care and treatment</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - pathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Angiopathies - pathology</subject><subject>Diabetic Angiopathies - physiopathology</subject><subject>Diabetics</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Leukoencephalopathies - pathology</subject><subject>Leukoencephalopathies - physiopathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine, Experimental</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Original Research</subject><subject>Predictive Value of Tests</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Severity of Illness Index</subject><subject>Software packages</subject><subject>Studies</subject><subject>Type 1 diabetes</subject><subject>Veins & arteries</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkt9uFCEUxidGY9fqhS-gpMYYL6bCADPMjcla_zWpcWPb9JIwzGGWZhdWmDXZB_I9PevWas2GBAjnd74Dh68onjJ6XHHevOktoyUTor5XTFjLZSmlUPeLCWWiLWXbVgfFo5yvKaVCKPWwOKhYxWpVV5Pi5wkk6JJZkBkkt84-BmJCT6Yxjd6S89E7FyBnMk1ATkMPK8ApjGSWoPd2jCmT6MjV3I9AvphxhETeJeMDmY4pruYbgtuLzQoII--96WCrOjOjRw0UzRm1oSdXfpxj-hB-x79BjsEEixWXZvBheFw8cGaR4cnNelhcfvxwcfK5PPv66fRkelZaWdOxtFwI17TWScE7SquWQVOLVlnedUo54ZzpHW8kZ0opw5u27mtgnTRSVC3G-GHxdqe7WndL6C1eElujV8kvTdroaLy-Gwl-rof4Q3NaCV43KPDqRiDF72vIo176bGGxMAHiOmslFBaXtUTy6D_yOq5TwNdpJSvZCPwhhF7soMEsQPvgIla1W0k9rUTLFVO0RarcQw0QAK8YAziPx3f44z08jh6W3u5NeL1LsCnmnMDddoRRvXWg3jpQbx2I7LN_W3hL_rEcAi9vAJOtWbiEH-3zX44rfDpjyD3fcc5EbYaEzOV5RRmnW4vXbcN_ASbR7Gg</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>van Elderen, Saskia G.C</creator><creator>Brandts, Anne</creator><creator>van der Grond, Jeroen</creator><creator>Westenberg, Jos J.M</creator><creator>Kroft, Lucia J.M</creator><creator>van Buchem, Mark A</creator><creator>Smit, Johannes W.A</creator><creator>de Roos, Albert</creator><general>American Diabetes Association</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110201</creationdate><title>Cerebral Perfusion and Aortic Stiffness Are Independent Predictors of White Matter Brain Atrophy in Type 1 Diabetic Patients Assessed With Magnetic Resonance Imaging</title><author>van Elderen, Saskia G.C ; Brandts, Anne ; van der Grond, Jeroen ; Westenberg, Jos J.M ; Kroft, Lucia J.M ; van Buchem, Mark A ; Smit, Johannes W.A ; de Roos, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-c344f79cf543b00291e76498c3bb88f4ffadf37531888a3796d6e1b5a5429fad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aortic Diseases - pathology</topic><topic>Atrophy</topic><topic>Biological and medical sciences</topic><topic>Brain</topic><topic>Brain Diseases - pathology</topic><topic>Brain Diseases - physiopathology</topic><topic>Care and treatment</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - pathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Angiopathies - pathology</topic><topic>Diabetic Angiopathies - physiopathology</topic><topic>Diabetics</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Leukoencephalopathies - pathology</topic><topic>Leukoencephalopathies - physiopathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medicine, Experimental</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Original Research</topic><topic>Predictive Value of Tests</topic><topic>Public health. Hygiene</topic><topic>Public health. 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RESEARCH DESIGN AND METHODS: Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA₁c. RESULTS: Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = -0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = -0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = -0.695, P < 0.001). CONCLUSIONS: Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>21216862</pmid><doi>10.2337/dc10-1446</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aortic Diseases - pathology Atrophy Biological and medical sciences Brain Brain Diseases - pathology Brain Diseases - physiopathology Care and treatment Cerebrovascular Circulation - physiology Diabetes Diabetes Mellitus, Type 1 - pathology Diabetes. Impaired glucose tolerance Diabetic Angiopathies - pathology Diabetic Angiopathies - physiopathology Diabetics Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Heart rate Humans Hypertension Leukoencephalopathies - pathology Leukoencephalopathies - physiopathology Magnetic Resonance Imaging Male Medical research Medical sciences Medicine, Experimental Metabolic diseases Middle Aged Miscellaneous Original Research Predictive Value of Tests Public health. Hygiene Public health. Hygiene-occupational medicine Severity of Illness Index Software packages Studies Type 1 diabetes Veins & arteries |
| title | Cerebral Perfusion and Aortic Stiffness Are Independent Predictors of White Matter Brain Atrophy in Type 1 Diabetic Patients Assessed With Magnetic Resonance Imaging |
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