Abstract
Abstract
Aims
To determine if arterial functional and structural changes are associated with underlying cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes.
Methods
We enrolled 186 individuals (47.8% men; median age 40.0, IQR 33.0—45.0 years) with type 1 diabetes (median diabetes duration of 21.6, IQR 18.2—30.3 years), and 30 age- and sex-matched healthy controls, as part of the Finnish Diabetic Nephropathy (FinnDiane) Study. All individuals underwent a biochemical work-up, brain magnetic resonance imaging (MRI), ultrasound of the common carotid arteries and arterial tonometry. Arterial structural and functional parameters were assessed by carotid intima-media thickness (CIMT), pulse wave velocity and augmentation index.
Results
Cerebral microbleeds (CMBs) were present in 23.7% and white matter hyperintensities (WMHs) in 16.7% of individuals with type 1 diabetes. Those with type 1 diabetes and CMBs had higher median (IQR) CIMT 583 (525 – 663) μm than those without 556 (502 – 607) μm, p = 0.016). Higher CIMT was associated with the presence of CMBs (p = 0.046) independent of age, eGFR, ApoB, systolic blood pressure, albuminuria, history of retinal photocoagulation and HbA1c. Arterial stiffness and CIMT were increased in individuals with type 1 diabetes and WMHs compared to those without; however, these results were not independent of cardiovascular risk factors.
Conclusions
Structural, but not functional, arterial changes are associated with underlying CMBs in asymptomatic individuals with type 1 diabetes.
Funder
Folkhälsan Research Foundation
Academy of Finland
Wilhelm and Else Stockmann Foundation
“Liv och Hälsa” Society
Novo Nordisk Foundation
Sigrid Juselius Foundation
Päivikki and Sakari Sohlberg Foundation
Finnish Foundation for Cardiovascular Research
Governmental research funding
Biomedicum Helsinki Foundation
Medical Society of Finland
Dorothea Olivia, Karl Walter and Jarl Walter Perklén’s Foundation
University of Helsinki
University of Helsinki including Helsinki University Central Hospital
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
9 articles.
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