title: Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study.
abstract: OBJECTIVE
  Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white matter hyperintensities.
  
  
  METHODS
  In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA was visually scored for the left and right medial temporal lobe (score 0-4), and meaned.
  
  
  RESULTS
  Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95% CI: 1.1-7.8) compared with an MTA score of 0 (no atrophy). The odds ratio for MTA score 2 was not significantly increased (OR 1.8; CI: 0.9-4). Systolic and diastolic blood pressure and a history of hypertension were not associated with MTA. There was no interaction between DM and hypertension. Stratification on white matter hyperintensities (WMH) did not alter the associations.
  
  
  CONCLUSIONS
  Our study strengthens the observation that MTA is associated with DM, independently of the amount of small vessel disease as reflected by WMH.
authors.affiliation: Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: E S C
authors.initials: ES
authors.lastname: Korf
authors.forename: E C W
authors.initials: EC
authors.lastname: van Straaten
authors.forename: F-E
authors.initials: FE
authors.lastname: de Leeuw
authors.forename: W M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: L
authors.initials: L
authors.lastname: Pantoni
authors.forename: A M
authors.initials: AM
authors.lastname: Basile
authors.forename: D
authors.initials: D
authors.lastname: Inzitari
authors.forename: T
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: L-O
authors.initials: LO
authors.lastname: Wahlund
authors.forename: E
authors.initials: E
authors.lastname: Rostrup
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
authors.forename: F
authors.initials: F
authors.lastname: Fazekas
authors.forename: P
authors.initials: P
authors.lastname: Scheltens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology; D003925:Diabetic Angiopathies / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D013702:Temporal Lobe / Q000473:pathology*