Tiehuis Audrey M, van der Graaf Yolanda, Visseren Frank L, Vincken Koen L, Biessels Geert Jan, Appelman Auke P A, Kappelle L Jaap, Mali Willem P T M
Stroke. 2008 May;39(5):1600-3. doi: 10.1161/STROKEAHA.107.506089. Epub 2008 Mar 27.
Diabetes type 2 (DM2) is associated with accelerated cognitive decline and structural brain abnormalities. Macrovascular disease has been described as a determinant for brain MRI changes in DM2, but little is known about the involvement of other DM2-related factors.
Brain MRI was performed in 1043 participants (151 DM2) with symptomatic arterial disease. Brain volumes were obtained through automated segmentation.
Patients with arterial disease and DM2 had more global and subcortical brain atrophy (-1.20% brain/intracranial volume [95%CI -1.58 to -0.82], P<0.0005 and 0.20% ventricular/intracranial volume [0.05 to 0.34], P<0.01), larger WMH volumes (0.22 logtransformed volume [0.07 to 0.38], P<0.005), and more lacunar infarcts (OR 1.75 [1.13 to 2.69], P<0.01) than identical patients without DM2. In patients with DM2, high glucose levels (B-0.12% per mmol/L [-0.23 to -0.01], P<0.05) and diabetes duration (B-0.05% per year [-0.10 to -0.001], P<0.05) were associated with global brain atrophy.
In patients with symptomatic arterial disease, DM2 has an added detrimental effect on the brain. In patients with DM2, hyperglycemia and diabetes duration contribute to brain atrophy.
2型糖尿病（DM2）与认知能力加速衰退及脑结构异常有关。大血管疾病被认为是DM2患者脑磁共振成像（MRI）变化的一个决定因素，但对于其他与DM2相关因素的影响知之甚少。
对1043名有症状性动脉疾病的参与者（151名DM2患者）进行了脑MRI检查。通过自动分割获得脑容量。
患有动脉疾病和DM2的患者比无DM2的相同患者有更多的全脑和皮质下脑萎缩（脑/颅内体积-1.20%[95%CI -1.58至-0.82]，P<0.0005；脑室/颅内体积0.20%[0.05至0.34]，P<0.01）、更大的白质高信号体积（0.22经对数转换的体积[0.07至0.38]，P<0.005）以及更多的腔隙性梗死（比值比1.75[1.13至2.69]，P<0.01）。在DM2患者中，高血糖水平（每毫摩尔/升-0.12%[-0.23至-0.01]，P<0.05）和糖尿病病程（每年-0.05%[-0.10至-0.001]，P<0.05）与全脑萎缩有关。
在有症状性动脉疾病的患者中，DM2对脑有额外的有害影响。在DM2患者中，高血糖和糖尿病病程会导致脑萎缩。
