Lucatelli Pierleone, Montisci Roberto, Sanfilippo Roberto, Sacconi Beatrice, Suri Jasjit S, Catalano Carlo, Saba Luca
Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy.
Department of Surgery, Section of Vascular Surgery, Azienda Ospedaliero Universitaria (AOU) of Cagliari-Polo di Monserrato, Cagliari, Italy.
J Neuroradiol. 2016 Jul;43(4):273-9. doi: 10.1016/j.neurad.2015.11.003. Epub 2015 Dec 28.
The relation between white matter loss (WML) and diabetes is still debated. The aim of this study was to investigate the correlation between typical WML- and diabetes-related magnetic resonance imaging (MRI) findings in a cohort of patients scheduled for carotid endarterectomy (CEA).
Ninety-three consecutive patients (mean age 71±9years; male 71) were included in a single-centre retrospective study. All the patients underwent MRI as baseline evaluation prior to CEA. A neuroradiologist blinded to the presence of risk factors calculated WML volume and number of lesions on FLAIR images using a semi-automated segmentation technique. Receiver operating characteristics analysis was performed to search for any association between WML volume and the number of WML lesions. The Mann-Whitney tests were used to determine significant WML differences between diabetic and non-diabetic patients. Logistic regression analysis was performed to evaluate the potential association of other variables.
The prevalence of diabetes was 20.4% (n=19). WML volume and number of WML lesions were significantly associated with diabetes (P=0.001). A statistically significant difference in WML volume was found between diabetic and non-diabetic patients (P<0.0001). Only diabetes, among all the investigated variables (WML volume, CAD status, age, smoking status, gender, hypertension, hyperlipidemia, diabetes) was significantly associated with WML (P=0.0001).
Our results demonstrate a strong statistical correlation between diabetes and WML. Future scientific challenges could include the identification of potential therapeutic targets and the creation of dedicated screening protocols for WML in diabetic patients other than the simple measurement of leukoaraiosis total burden.
脑白质丢失（WML）与糖尿病之间的关系仍存在争议。本研究的目的是在一组计划接受颈动脉内膜切除术（CEA）的患者中，调查典型的WML与糖尿病相关的磁共振成像（MRI）表现之间的相关性。
一项单中心回顾性研究纳入了93例连续患者（平均年龄71±9岁；男性71例）。所有患者在CEA术前均接受MRI作为基线评估。一名对危险因素不知情的神经放射科医生使用半自动分割技术计算了液体衰减反转恢复（FLAIR）图像上的WML体积和病变数量。进行了受试者操作特征分析，以寻找WML体积与WML病变数量之间的任何关联。采用曼-惠特尼检验确定糖尿病患者和非糖尿病患者之间WML的显著差异。进行逻辑回归分析以评估其他变量的潜在关联。
糖尿病患病率为20.4%（n = 19）。WML体积和WML病变数量与糖尿病显著相关（P = 0.001）。糖尿病患者和非糖尿病患者之间WML体积存在统计学显著差异（P < 0.0001）。在所有调查变量（WML体积、冠状动脉疾病状态、年龄、吸烟状态、性别、高血压、高脂血症、糖尿病）中，只有糖尿病与WML显著相关（P = 0.0001）。
我们的结果表明糖尿病与WML之间存在很强的统计学相关性。未来的科学挑战可能包括确定潜在的治疗靶点，以及为糖尿病患者制定专门的WML筛查方案，而不仅仅是简单测量脑白质疏松症的总负担。
