Changes in cerebral blood flow detected by SPECT in type 1 and type 2 diabetic patients.
Although macrovascular complications are typical for type 2 diabetes mellitus (T2DM), cerebral microvascular damage develops both in type 1 diabetes mellitus (T1DM) and T2DM. Color Doppler ultrasound is widely used for the examination of large- and medium-sized arteries, whereas SPECT and MRI are capable of identifying disturbances in the circulation of microvessels. Former studies using semiquantitative methods showed reduced reactivity and reserve capacity of cerebral vessels in both T1DM and T2DM patients. Our aim was to investigate whether there was any difference in the effects of the 2 types of diabetes mellitus on the global or regional cerebral blood flow, influenced by microvascular damage.


METHODS
In our study, the circulation and reserve capacity of cerebral arteries was examined using (99m)Tc-hexamethylpropylene amine oxime SPECT. A total of 17 individuals with T1DM and 43 individuals with T2DM were involved in the study.


RESULTS
Both basal and acetazolamide-challenged brain circulation were significantly lower in T2DM patients than in T1DM patients. We did not find a significant difference in the reserve capacity. However, the circulation of the frontal and occipital lobes changed differently in the 2 groups. The ratio of the circulation of the frontal and occipital lobes was significantly reduced both in basal and in acetazolamide-stimulated states in T2DM patients, independently of age (P < 0.0005 and P < 0.017), showing a greater relative decrease in the circulation of the frontal lobe in T2DM patients.


CONCLUSIONS
There was a significant association between basal brain circulation and age, body mass index, and high-density lipoprotein (HDL), whereas acetazolamide-stimulated circulation showed a significant association with serum triglyceride and HDL.
Káplár
Miklós
M
1st Department of Internal Medicine, University of Debrecen Medical and Health Science Center, Debrecen, Hungary. mkaplar@internal.med.unideb.hu
Paragh
György
G
Erdei
Annamária
A
Csongrádi
Eva
E
Varga
Eva
E
Garai
Ildikó
I
Szabados
Lajos
L
Galuska
László
L
Varga
József
J
D000328:Adult; D002560:Cerebrovascular Circulation; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D019690:Technetium Tc 99m Exametazime