In:
Annals of the Academy of Medicine, Singapore, Academy of Medicine, Singapore, Vol. 36, No. 4 ( 2007-4-15), p. 259-266
Abstract:
Introduction: The aim of the study was to evaluate cerebral microangiopathy in type 2 non-insulin-dependent diabetes mellitus (NIDDM) patients and to establish potentially conducive factors.
Materials and Methods: A group of 34 patients with NIDDM and 31 gender- and age-matched normal controls (NC ) were assessed by extracranial Doppler ultrasound, in order to evaluate the pulsatility index (PI) and the resistance index (RI) in the internal carotid arteries (ICAs); transcranial Doppler was utilised to assess the same parameters in the middle cerebral arteries (MCAs). All patients underwent screening for favouring factors for cerebral vascular remodelling.
Results: Of the 34 NIDDM patients, 21 patients (61.76%) (subgroup A) presented with microangiopathic complications [of these, 19 patients (90.46%) had diabetic nephropathy (DN)] versus 13 NIDDM patients (38.24%) (subgroup B) without complications. In subgroup A, 16 patients (76.19%) had PI 〉 1 and RI 〉 0.7 in the ICAs and MCAs (changes consistent with cerebral microangiopathy) versus 5 patients (35.46%) in subgroup B, and no modifications in NC. Of the 19 patients with DN, 14 patients (73.68 %) had impaired haemodynamic indices. Univariate regression analysis showed the following risk factors for the cerebral haemodynamics changes: fibrinogen (F) (OR = 3.11), C-reactive protein (CRP) (OR = 2.40), duration of DM (OR=2.40), proteinuria (OR = 1.80), serum creatinine (OR = 1.66). Multivariate regression analysis showed as predictors for impaired haemodynamic indices: duration of DM (HR =1.70), proteinuria (HR = 1.70). The haemodynamic indices in the ICAs correlated with duration of DM (r = 0.87, P 〈 0.0001), F (r = 0.86; P 〈 0.0001), CRP (r = 0.80; P 〈 0.0001); in the MCAs with the duration of DM (r = 0.66, P 〈 0.0001), F (r = 0.38; P 〈 0.0001), CRP (r = 0.88; P 〈 0.0001).
Conclusion: Cerebral microangiopathy has a high prevalence in NIDDM patients. These cerebral vascular changes correlate with the duration of DM, parameters of inflammation, and proteinuria. Key words: Cerebral microangiopathy, Diabetic nephropathy, Doppler ultrasound, Non-insu-lin-dependent diabetes mellitus, Risk factors
Type of Medium:
Online Resource
ISSN:
0304-4602
DOI:
10.47102/annals-acadmedsg.
DOI:
10.47102/annals-acadmedsg.V36N4p259
Language:
English
Publisher:
Academy of Medicine, Singapore
Publication Date:
2007
detail.hit.zdb_id:
2186627-2
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