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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血糖波动对2型糖尿病患者白质高强度的影响

目的：平均血糖偏移幅度（MAGE）被广泛认为是葡萄糖波动程度的代表，但其在脑血管疾病中的意义尚不清楚。本研究旨在探讨MAGE与白质高强度（WMH）的相关性。材料与方法：本横断面研究时间为2021年3月至2022年10月，纳入212例年龄在50 - 80岁之间的2型糖尿病患者。参与者接受了核磁共振扫描和连续血糖监测。收集临床和实验室数据进行分析。使用Fazekas视觉评定量表和定量方法评估WMH体积。根据Fazekas评分将患者分为低水平WMH组（L-WMH, n = 88）和高水平WMH组（H-WMH, n = 124）。结果：与L-WMH组相比，H-WMH组的MAGE水平明显升高。TBR是MAGE升高的独立危险因素。MAGE和TBR均与WMH负担增加独立相关。此外，MAGE被确定为TBR和WMH体积之间关系的部分中介。结论：MAGE和低血糖与糖尿病患者WMH有独立的相关性。此外，低血糖可能通过增加葡萄糖波动间接影响WMH的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.