Impact of fasting glycemia and regional cerebral perfusion in diabetic subjects: a study with technetium-99m-ethyl cysteinate dimer single photon emission computed tomography.
OBJECTIVE
Diabetes mellitus increases the risk of ischemic stroke. The aim of this study was to investigate the correlation between fasting plasma glucose (FPG) and changes in regional cerebral perfusion (CP) in subjects with DM.


METHODS
CP was assessed in 24 subjects (mean age 44+/-2.5 years) with type 1 diabetes mellitus by single photon emission computed tomography.


RESULTS
Analysis of CP during elevated FPG (224+/-24 mg/dL) showed 3 or more deficits in 42% of the subjects. A positive relationship between the number of CP deficits and FPG was observed (P<0.01), but not with age, sex, body mass index, or duration of diabetes mellitus. Regional deficits were reduced (P<0.001) with improvement in FPG (119+/-5 mg/dL). This reduction remained significant after adjustment for age, sex, and body mass index. Plasma levels of P-selectin, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1, established markers of endothelial dysfunction, were significantly decreased with lower FPG. Furthermore, thiobarbituric acid reactive substance plasma levels, an index of oxidative stress, were also reduced (P<0.01).


CONCLUSIONS
The present study demonstrates that changes in FPG are associated with functional changes in regional CP. Hyperglycemia-induced endothelial dysfunction may be implicated in the impaired regional CP of diabetic subjects.
Francesco
F
Cosentino
Rodolfo
R
Battista
Angelo
A
Scuteri
Francesco
F
De Sensi
Luca
L
De Siati
Carmen
C
Di Russo
Giovanni G
GG
Camici
Massimo
M
Volpe
D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001786:Blood Glucose / Q000502:physiology; D015984:Causality; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D003545:Cysteine / Q000031:analogs & derivatives*; D048909:Diabetes Complications / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D042783:Endothelial Cells / Q000378:metabolism; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D018384:Oxidative Stress / Q000502:physiology; D019007:P-Selectin / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D015609:Organotechnetium Compounds; D019007:P-Selectin; D019275:Radiopharmaceuticals; D017392:Thiobarbituric Acid Reactive Substances; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; C059659:technetium Tc 99m bicisate; D003545:Cysteine