Aortic stiffness is associated with white matter integrity in patients with type 1 diabetes.
OBJECTIVE
To assess the association between aortic pulse wave velocity (PWV) as a marker of arterial stiffness and diffusion tensor imaging of brain white matter integrity in patients with type 1 diabetes using advanced magnetic resonance imaging (MRI) technology.


METHODS
Forty-one patients with type 1 diabetes (23 men, mean age 44 ± 12 years, mean diabetes duration 24 ± 13 years) were included. Aortic PWV was assessed using through-plane velocity-encoded MRI. Brain diffusion tensor imaging (DTI) measurements were performed on 3-T MRI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated for white and grey matter integrity. Pearson correlation and multivariable linear regression analyses including cardiovascular risk factors as covariates were assessed.


RESULTS
Multivariable linear regression analyses revealed that aortic PWV is independently associated with white matter integrity FA (β = -0.777, p = 0.008) in patients with type 1 diabetes. This effect was independent of age, gender, mean arterial pressure, body mass index, smoking, duration of diabetes and glycated haemoglobin levels. Aortic PWV was not significantly related to grey matter integrity.


CONCLUSIONS
Our data suggest that aortic stiffness is independently associated with reduced white matter integrity in patients with type 1 diabetes.


CONCLUSIONS
Aortic stiffness is associated with brain injury. Aortic stiffness exposes small vessels to high pressure fluctuations and flow. Aortic stiffness is associated with microvascular brain injury in diabetes. This suggests a vascular contribution to early subtle microstructural deficits.
Department of Endocrinology and General Internal Medicine (C7-Q), Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, Netherlands, n.tjeerdema@lumc.nl.
Nathanja
N
Tjeerdema
Linda D
LD
Van Schinkel
Jos J
JJ
Westenberg
Saskia G
SG
Van Elderen
Mark A
MA
Van Buchem
Johannes W
JW
Smit
Jeroen
J
Van der Grond
Albert
A
De Roos
D000328:Adult; D016880:Anisotropy; D001013:Aorta, Thoracic / Q000473:pathology / Q000503:physiopathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D063177:Pulse Wave Analysis; D012189:Retrospective Studies; D059289:Vascular Stiffness; D066127:White Matter / Q000473:pathology*