Impact of glucose fluctuations on white matter hyperintensity in type 2 diabetic patients.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2025-02-25 DOI:10.1007/s00592-025-02471-w

Xin Chen, Wanbing Qian, Xin Wang, Jianrong Yao, Yazhou Ma, Xuegan Lian

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引用次数: 0

Abstract

Objectives: The mean amplitude of glycemic excursion (MAGE) is widely recognized for representing glucose fluctuation extent, its implications in cerebral small vessel disease remain unclear. This study aims to investigate the correlation between MAGE and white matter hyperintensity (WMH).

Materials and methods: This cross-sectional study, spanning from March 2021 to October 2022, included 212 type 2 diabetic patients aged between 50 and 80. Participants underwent MRI scans and continuous glucose monitoring. Clinical and laboratory data were compiled for analysis. WMH volumes were evaluated using both the Fazekas visual rating scale and a quantitative approach. Based on Fazekas scores, patients were categorized into low level of WMH (L-WMH, n = 88) and high level of WMH (H-WMH, n = 124) groups.

Results: MAGE levels were significantly higher in the H-WMH group compared to the L-WMH group. Time below range [TBR^< 3.9] emerged as an independent risk factor for elevated MAGE. Both MAGE and TBR^< 3.9 independently correlated with an increased WMH burden. Additionally, MAGE was identified as a partial mediator in the relationship between TBR^< 3.9 and WMH volumes.

Conclusion: MAGE and hypoglycemia exhibit independent associations with WMH in diabetic patients. Moreover, hypoglycemia may indirectly influence WMH progression through the augmentation of glucose fluctuations.

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.