ECE2018 Guided Posters Diabetes Translational (12 abstracts)
Background and aims: Cerebrovascular reactivity (CVR) impairment was reported as a marker of cerebral microangiopathy in long-term type 1 diabetes (DM1). Indices of cerebral blood flow might serve as an indicator of early microangiopathic complications. The aim of this study was to evaluate CVR in patients with DM1 and diabetic nephropathy. Research design and methods: Study has been reviewed by the Local Ethics Committee. The study has been performed in accordance with ethical standards laid down in the Helsinki Declaration. Peak systolic blood flow velocity (S) in the middle cerebral artery (MCA) before (S1) and after (S2) compression of the ipsilateral common carotid artery (CCA) and the index of vasomotor reactivity (VMRr=(S2S1)×100/S1) were measured with transcranial duplex sonography in 41 patients (age 28.9±6.2 years, duration of DM1 15±4 years, HbA1c 8.9±1,8%) with DM1, without history of cerebrovascular events, and 22 healthy control subjects (age 26.3±4.2 years). The study included patients with normoalbuminuria AER in the morning urine <20 mg/l (n=22); microalbuminuria AER<199 mg/l (n=12); macroalbuminuria AER ≥200 mg/l (n=7). A decrease of glomerular filtration rate (GFR) of 4559 ml/min per 1.73 m2 was noted in 6 patients, in 35 patients with GFR≥60 ml/min per 1.73 m2. Statistical analysis was performed with SPSS 22,0 for Windows, P<0.05.
Results: There was statistically significant decrease of VMRr in patients with DM1 compared with control group (P=0.01) (
Conclusion: The CVR was reduced in patients with DM1. In patients with diabetic nephropathy (macroalbuminuria or GFR<60 ml/min per 1.73 m2), the ability of the MCA to change diameter under the influence of mechanical factor is reduced that leads to a disruption in the ability of the cerebral circulation to compensate a hemodynamic deficit. Diabetic nephropathy can indicate the severity of cerebral microangiopathy in patients with DM1.
19 May 2018 - 22 May 2018