Female type 2 diabetes mellitus mice exhibit severe ischemic brain damage

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are risk factors for the spectrum of brain lesions. In this paper, we studied the impact of T2DM and HTN on the incidence of several brain lesions diagnosed with magnetic resonance imaging (MRI). Methods and Results: This retrospective, single-center study was conducted at Royal Care International Hospital (Khartoum, Sudan) from January 2016 to December 2016 and included 80 patients (40 male and 40 female, aged between 20 years and 90 years) with suspected brain disorders. MRI brain examinations were conducted on a 1.5 Tesla MRI system (Toshiba Medical Systems, Tokyo, Japan). The following sequences were analyzed: T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). Brain lesions were characterized by magnetic imaging spectroscopy and histopathological analysis. Binary logistic regression analysis was used to establish a mathematical model of the relationship between T2DM/HTN and the prevalence of brain lesions. Among 80 patients, HTN, T2D, and the combination of T2D and HTN were identified in 18(22.5%), 9(11.2%), and 11(13.8%) patients, respectively. Brain lesions were found in 48(60%) patients and were most prevalent in the age group of 66-80 years. The brain lesions included ischemic brain infarction (IBI) (22.5%), brain tumors (11.2%), cerebral hemorrhages (6.2%), brain atrophy (BA) (1.2 %), IBI with BA (16.2%), and brain metastases (2.5%). Regression analysis showed that HTN and T2DM were associated with significantly higher ORs for brain lesions ([OR=2.459, 95% CI: 1.673–3.614, P<0.001] and [OR=1.507, 95% CI: 1.067–2.128, P= 0.042], and [OR=1.078, 95% CI:1.033–1.124, P=0.001], respectively). HTN was associated with significantly higher OR for ischemic brain infarction (OR=7.404, 95% CI: 2.600–21.081, P<0.001). Conclusion: The study showed a significant interaction between HTN and T2DM on the prevalence of brain lesions, especially ischemic brain infarction and brain atrophy.

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Microangiopathy is associated with bone loss in female type 2 diabetes mellitus patients

Diabetes and Vascular Disease Research ◽

10.1177/1479164118779386 ◽

2018 ◽

Vol 15 (5) ◽

pp. 433-441 ◽

Cited By ~ 4

Author(s):

Ni Zhong ◽

Youyang Zhang ◽

Xiangling Pu ◽

Bei Xu ◽

Mingxin Xu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Bone Mineral Density ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Bone Mineral ◽

Mineral Density ◽

Urine Protein ◽

Group Iii ◽

Female Type

Objective: Type 2 diabetes mellitus complicated with microvascular diseases can be used as a model to study the relationship between bone health and the microvascular situation. Methods: A total of 2,170 patients with type 2 diabetes mellitus (1,188 postmenopausal females and 982 males aged ⩾50 years) were included in our cross-sectional study. These patients were grouped according to 24-hour urine protein level: Group I (<30 mg), Group II (30-299 mg) and Group III (≥300 mg). Bone mineral density of the lumbar spine, hip and femoral neck was evaluated by dual-energy X-ray absorptiometry. Fundus oculi photography for diabetic retinopathy and 24-h urine protein for diabetic nephropathy were used as markers of microangiopathy in type 2 diabetes mellitus. Characteristics of the patients and bone mineral density were compared. Multivariate analysis was used to study the association between bone mineral density and microangiopathy. Statistical analysis was performed using SPSS 20.0. p < 0.05 was considered statistically significant. Results: Group III had the lowest bone mineral density level in both genders. Multivariate analysis revealed that microangiopathy was negatively correlated with bone mineral density in females (lumbar: r = –0.522, p < 0.001; hip: r = –0.301, p = 0.010; femoral neck: r = –0.314, p = 0.009), but not in males, after adjustment for age, body mass index, hypertension, hyperlipidemia, diabetic status, hepatic function, kidney function, sex hormones and 25(OH) vitamin D. Conclusion: These results demonstrate an independent negative correlation between microangiopathy and bone mineral density in postmenopausal female type 2 diabetes mellitus patients.

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Altered Functional Connectivity of Insular Subregions in Type 2 Diabetes Mellitus

Frontiers in Neuroscience ◽

10.3389/fnins.2021.676624 ◽

2021 ◽

Vol 15 ◽

Author(s):

Dongsheng Zhang ◽

Man Wang ◽

Jie Gao ◽

Yang Huang ◽

Fei Qi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Functional Connectivity ◽

Brain Damage ◽

Anterior Insula ◽

Precentral Gyrus ◽

Cognitive Variables ◽

The Right

Diabetes-related brain damage can lead to cognitive decline and increase the risk of depression, but the neuropathological mechanism of this phenomenon remains unclear. Different insular subregions have obvious functional heterogeneity, which is related to many aspects of type 2 diabetes mellitus (T2DM)-related brain damage. However, little is known about changes in functional connectivity (FC) in insular subregions in patients with T2DM. Therefore, we aimed to investigate FC between different insular subregions and clinical/cognitive variables in patients with T2DM. Fifty-seven patients with T2DM and 55 healthy controls (HCs) underwent a neuropsychological assessment and resting-state FC examination. We defined three insular subregions, including the bilateral dorsal anterior insula (dAI), bilateral ventral anterior insula (vAI), and bilateral posterior insula (PI). We examined differences in FC between insular subregions and the whole brain in patients with T2DM compared with HCs. A correlation analysis was performed to examine the relationship between FC and clinical/cognitive variables. Compared with HCs, patients with T2DM showed significantly decreased FC between the dAI and the right inferior frontal gyrus, right superior/middle temporal gyrus, right hippocampus, and right precentral gyrus. FC between the vAI and the right supramarginal gyrus, as well as the PI and the right precentral/postcentral gyrus, was reduced in the T2DM group compared with the control group. In the T2DM group, we showed a significant negative correlation between glycated hemoglobin concentration and FC in the dAI and right hippocampus (r = −0.428, P = 0.001) after Bonferroni correction. We conclude that different insular subregions present distinct FC patterns with functional regions and that abnormal FC in these insular subregions may affect cognitive, emotional, and sensorimotor functions in patients with T2DM.

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Symptomatic and silent cerebral ischemia (detected on MRI) in patients with type 2 diabetes mellitus after carotid revascularization procedures

Diabetes Mellitus ◽

10.14341/dm9633 ◽

2019 ◽

Vol 22 (1) ◽

pp. 14-24

Author(s):

Marine M. Tanashyan ◽

Ksenia V. Antonova ◽

Roman B. Medvedev ◽

Sergey I. Skrylev ◽

Marina V. Krotenkova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Factor ◽

Brain Damage ◽

Plasma Glucose ◽

Carotid Atherosclerosis ◽

Baseline Hba1c ◽

Hba1c Levels

Background: Type 2 diabetes mellitus (T2DM) is a significant independent risk factor for ischaemic stroke. Carotid revascularisation procedures are an effective method of primary and secondary stroke prevention. However, patients developed postoperative acute ischaemic lesions (AILs), which were identified via magnetic resonance imaging (MRI) of the brains. Most of the patients with these AILs lack clinically overt symptoms. Aims: To assess the risk of ischaemic brain damage in patients with T2DM in the setting of carotid angioplasty with stenting (CAS) or carotid endarterectomy (CAE). Materials and methods: This open prospective study comprised of 164 patients with carotid atherosclerosis, who have undergone either CAS or CAE. Patients with T2DM were included in Group 1: 38 patients and 28 patients with CAE. Group 2 included patients without T2DM: 62 patients with CAS and 36 patients with CAE. All patients underwent a thorough neurological examination and diffusion-weighted brain MRI. In patients with T2DM, plasma glucose levels and glycated haemoglobin (HbA1c) were determined and their relationships to brain damage were evaluated. Results: In CAS, there were no statistically significant differences in the AIL frequency in patients with and without T2DM. AILs were found in 15 patients with T2DM (39.8%) and 29 patients without T2DM (46.8%, р = 0.24); three patients without T2DM were diagnosed with stroke. Of the 28 patients with T2DM who underwent CAE, 13 had AIL (46.4%); three had stroke (10.7%). In patients without T2DM, AILs were less prevalent in seven cases (19.4%, р = 0.012) and appeared asymptomatic. Following CAS, the baseline HbA1c levels were higher in patients with T2DM who developed AILs compared to those who did not develop AIL, 7.8% 1.4% vs 7.1 1.1% (р = 0.0469). Negative impact of hyperglycaemia on the risk of cerebral ischaemia was observed in patients who underwent CAE, the baseline fasting plasma glucose level was 8.5 1.9 mmol/l vs 7.0 1.5 mmol/l in patients without AIL (р = 0.014). The baseline HbA1c levels in patients with and without AILs were 8.0% 1.7% and 6.9% 0.9% respectively (р = 0.023). Conclusions: Carotid revascularisation procedure for patients with carotid atherosclerosis may be associated with risk of stroke and asymptomatic acute cerebral ischaemic lesions, which are more prevalent in patients with T2DM. Also, increased HbA1c levels is a risk factor for AIL.

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