Increased Burden of Cerebral Small Vessel Disease in Patients With Type 2 Diabetes and Retinopathy

View/ Open
Issue date
2016-06-08Author
Sanahuja Montesinos, Jordi
Alonso, Núria
Diez, Javier
Ortega, Emilio
Traveset Maeso, Alicia
Castelblanco Echavarría, Esmeralda
Arcidiacono, Maria V.
Jurjo Campo, Carmen
Puig-Domingo, Manuel
Groop, Per-Henrik
Suggested citation
Sanahuja Montesinos, Jordi;
Alonso, Núria;
Diez, Javier;
Ortega, Emilio;
Rubinat, Esther;
Traveset Maeso, Alicia;
...
Mauricio Puente, Dídac.
(2016)
.
Increased Burden of Cerebral Small Vessel Disease in Patients With Type 2 Diabetes and Retinopathy.
Diabetes Care, 2016, vol. 39, núm. 9, p. 1614-1620.
https://doi.org/10.2337/dc15-2671.
Metadata
Show full item recordAbstract
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.