Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Chronic Disease Epidemiology Branch, Community Health Improvement Division, Texas Department of State Health Services, Austin, TX, USA.
J Diabetes Complications. 2022 Feb;36(2):108084. doi: 10.1016/j.jdiacomp.2021.108084. Epub 2021 Nov 14.
We aimed to determine if neuroimaging characteristics of gray and white matter are associated with gait speed in middle-aged individuals with childhood-onset type 1 diabetes (T1D), and whether associations are independent of diabetic peripheral neuropathy (DPN) status.
In a cohort of 100 middle-aged adults with childhood-onset T1D (aged 49.2 ± 7.0 years, 50F/50M), we assessed cross-sectional associations of DPN, severity of white matter hyperintensities (WMH; Fazekas score), and regional gray matter volume (GMV) with gait speed. Associations were tested separately and combined in linear regression models adjusted for diabetes duration and locomotor risk factors.
Average gait speed was 1.3 m/s, with 52% of participants walking below the age-appropriate range of 1.3-1.5 m/s. In separate models, higher WMH severity (β = -0.27, p = 0.01) and smaller caudate GMV (β = -0.21, p = 0.04), but not DPN (β = -0.20, p = 0.08) were associated with slower gait speed. When combined, only WMH severity remained significant (β = -0.22, p = 0.04).
More than half of participants walked more slowly than expected based on age. Gait speed was slower among those with more severe WMH independent of locomotor risk factors. Gait slowing in middle-aged persons with T1D may reflect brain changes, and thus, deserve further attention.
我们旨在确定灰质和白质的神经影像学特征是否与中年起病的 1 型糖尿病（T1D）患者的步速有关，以及这些关联是否独立于糖尿病周围神经病变（DPN）状态。
在一项中年起病的 T1D 患者队列中（年龄 49.2±7.0 岁，50 名女性/50 名男性），我们评估了 DPN、白质高信号（WMH；Fazekas 评分）严重程度和区域灰质体积（GMV）与步速的横断面关联。关联在单独的线性回归模型中进行了测试，并在调整了糖尿病病程和运动风险因素后进行了组合。
平均步速为 1.3m/s，有 52%的参与者步速低于 1.3-1.5m/s 的年龄适当范围。在单独的模型中，更高的 WMH 严重程度（β=-0.27，p=0.01）和更小的尾状核 GMV（β=-0.21，p=0.04）与较慢的步速相关，但 DPN 无相关性（β=-0.20，p=0.08）。当结合起来时，只有 WMH 严重程度仍然具有显著性（β=-0.22，p=0.04）。
超过一半的参与者的步速比基于年龄预期的要慢。与运动风险因素无关，WMH 更严重的患者步速更慢。T1D 中年患者的步态减慢可能反映了大脑的变化，因此值得进一步关注。
