Assessment of Brain Lesions in Type 2 Diabetes Mellitus and Hypertension using Magnetic Resonance imaging

Abstract

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are risk factors for the spectrum of brain lesions. In this paper, we studied the impact of T2DM and HTN on the incidence of several brain lesions diagnosed with magnetic resonance imaging (MRI). Methods and Results: This retrospective, single-center study was conducted at Royal Care International Hospital (Khartoum, Sudan) from January 2016 to December 2016 and included 80 patients (40 male and 40 female, aged between 20 years and 90 years) with suspected brain disorders. MRI brain examinations were conducted on a 1.5 Tesla MRI system (Toshiba Medical Systems, Tokyo, Japan). The following sequences were analyzed: T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). Brain lesions were characterized by magnetic imaging spectroscopy and histopathological analysis. Binary logistic regression analysis was used to establish a mathematical model of the relationship between T2DM/HTN and the prevalence of brain lesions. Among 80 patients, HTN, T2D, and the combination of T2D and HTN were identified in 18(22.5%), 9(11.2%), and 11(13.8%) patients, respectively. Brain lesions were found in 48(60%) patients and were most prevalent in the age group of 66-80 years. The brain lesions included ischemic brain infarction (IBI) (22.5%), brain tumors (11.2%), cerebral hemorrhages (6.2%), brain atrophy (BA) (1.2 %), IBI with BA (16.2%), and brain metastases (2.5%). Regression analysis showed that HTN and T2DM were associated with significantly higher ORs for brain lesions ([OR=2.459, 95% CI: 1.673–3.614, P<0.001] and [OR=1.507, 95% CI: 1.067–2.128, P= 0.042], and [OR=1.078, 95% CI:1.033–1.124, P=0.001], respectively). HTN was associated with significantly higher OR for ischemic brain infarction (OR=7.404, 95% CI: 2.600–21.081, P<0.001). Conclusion: The study showed a significant interaction between HTN and T2DM on the prevalence of brain lesions, especially ischemic brain infarction and brain atrophy.