title: Diabetic symmetric polyneuropathy is associated with increased aortal stiffening but not cerebral angiopathy in type 1 diabetes.
abstract: BACKGROUND
  Diabetic symmetric polyneuropathy (DSP) and cerebral microangiopathy are common complications of type 1 diabetes (T1DM). However, little is known about associations between DSP, cerebral microcirculation and macrovascular injury in T1DM. We aimed to assess relationships between those complications.
  
  
  METHODS
  We examined 42 patients (25 females; mean age 37.1±5.6years) with T1DM (mean disease duration 20.6±6.1years). DSP was diagnosed with the use of quantitative vibration sensory testing (QVST) and Michigan Neuropathy Screening Instrument (MNSI). Cerebral microvasculature was evaluated with measurements of vasomotor reactivity reserve (VMR) and pulsatility index (PI) of middle cerebral artery, macroangiopathic injury by measuring intima-media complex thickness (IMT) in the common carotid artery and carotid-femoral pulse-wave velocity (PWV).
  
  
  RESULTS
  Patients with DSP (33.3%) showed higher PWV than those without DPS (10.5 vs 9.1m/s; P=0.03); no differences concerning VMR, PI or IMT existed. There were correlations between PWV and vibration perception thresholds (VPT) (r=0.44; P=0.004) and MNSI score (r=0.43; P=0.003); VPT showed impact on PWV (beta 0.34; P<0.03).
  
  
  CONCLUSIONS
  DSP is associated with systemic macroangiopathy, reflected by increased carotid-femoral PWV, but not with the cerebral macro- and microangiopathy.
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: sseba@gumed.edu.pl.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szczyrba
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Grzegorz M
authors.initials: GM
authors.lastname: Kozera
authors.affiliation: Department of Clinical Physiology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Neubauer-Geryk
authors.affiliation: Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Bogumił
authors.initials: B
authors.lastname: Wolnik
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Walenty M
authors.initials: WM
authors.lastname: Nyka
authors.affiliation: Department of Clinical Physiology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Bieniaszewski
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D059345:Cerebral Small Vessel Diseases / Q000175:diagnosis / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis / Q000379:methods; D012016:Reference Values; D018570:Risk Assessment; D018608:Ultrasonography, Doppler; D059289:Vascular Stiffness
keywords: Cerebral microangiopathy; Diabetic symmetric polyneuropathy; Doppler ultrasound; Quantitative sensory testing; Systemic macroangiopathy; Type 1 diabetes