Key result
In neurologically asymptomatic individuals with type 1 diabetes, higher carotid intima-media thickness was independently associated with the presence of cerebral microbleeds.
Why the study?
To determine whether arterial functional and structural changes are associated with underlying cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes.
Are arterial functional and structural changes associated with underlying cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes?
Cross-Sectional (n=216)
Single-blind
Yes
Are arterial functional and structural changes associated with underlying cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes?
In neurologically asymptomatic individuals with type 1 diabetes, increased carotid intima-media thickness is independently associated with the presence of cerebral microbleeds, suggesting a link between subclinical systemic atherosclerosis and early-onset cerebral microvascular pathology.
Answers are grounded in this paper and cite their sources.
Should not yet change cerebral imaging practices in asymptomatic T1D; hypothesis-generating for longitudinal vascular studies.
Aims To determine if arterial functional and structural changes are associated with underlying cerebral small vessel disease in neurologically asymptomatic individuals with type 1 diabetes. Methods We enrolled 186 individuals (47.8% men; median age 40.0, IQR 33.0—45.0 years) with type 1 diabetes (median diabetes duration of 21.6, IQR 18.2—30.3 years), and 30 age- and sex-matched healthy controls, as part of the Finnish Diabetic Nephropathy (FinnDiane) Study. All individuals underwent a biochemical work-up, brain magnetic resonance imaging (MRI), ultrasound of the common carotid arteries and arterial tonometry. Arterial structural and functional parameters were assessed by carotid intima-media thickness (CIMT), pulse wave velocity and augmentation index. Results Cerebral microbleeds (CMBs) were present in 23.7% and white matter hyperintensities (WMHs) in 16.7% of individuals with type 1 diabetes. Those with type 1 diabetes and CMBs had higher median (IQR) CIMT 583 (525 – 663) μm than those without 556 (502 – 607) μm, p = 0.016). Higher CIMT was associated with the presence of CMBs (p = 0.046) independent of age, eGFR, ApoB, systolic blood pressure, albuminuria, history of retinal photocoagulation and HbA1c. Arterial stiffness and CIMT were increased in individuals with type 1 diabetes and WMHs compared to those without; however, these results were not independent of cardiovascular risk factors. Conclusions Structural, but not functional, arterial changes are associated with underlying CMBs in asymptomatic individuals with type 1 diabetes.
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Inkeri et al. (2021) conducted a cross-sectional in Type 1 diabetes (n=216). Cerebral microbleeds (CMBs) vs. Absence of CMBs was evaluated on Carotid intima-media thickness (CIMT) (OR 1.005, 95% CI 1.000-1.010, p=0.046). In neurologically asymptomatic individuals with type 1 diabetes, higher carotid intima-media thickness was independently associated with the presence of cerebral microbleeds.
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