title: Diabetes mellitus and white matter hyperintensity.
abstract: White matter hyperintensity (WMH) is a brain lesion detected as a high-intensity area in magnetic resonance imaging T2 and fluid-attenuated inversion recovery images, and it has been suggested that WMH reflects damage to small vessels in periventricular and subcortical areas. Although WMH has been linked to the incidence of stroke, more recently it has been clarified that WMH is also associated with progression of cognitive decline and functional disability, which are components of so-called geriatric syndrome. In addition to hypertension, which is the classical risk factor for WMH, evidence has been accumulating to suggest that diabetes mellitus could also be associated with WMH progression, and some studies have shown that WMH severity is correlated with cognitive decline in patients with diabetes. The factors that accelerate WMH formation in elderly patients with diabetes remain poorly defined. It is considered that insulin resistance is an exacerbating factor, but the effects of hypertension, dyslipidemia or other vascular risk factors have yet be clarified, and further studies are required.
authors.affiliation: Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D015994:Incidence; D007333:Insulin Resistance / Q000502:physiology*; D049292:Leukoaraiosis / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology
keywords: deep white matter hyperintensity; diabetes mellitus; geriatric syndrome; paraventricular leukoaraiosis; white matter hyperintensity