White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio
Aims: Although evidence has accumulated that white matter hyperintensity (WMH) is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL), the clinical relevance of WMH in elderly patients with diabetes mellitus (DM) is not still clear. The aim of t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-07-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fnagi.2017.00220/full |
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| author | Yoshiaki Tamura Yoshiyuki Kimbara Takuya Yamaoka Ken Sato Yuki Tsuboi Remi Kodera Yuko Chiba Seijiro Mori Yoshinori Fujiwara Aya M. Tokumaru Hideki Ito Takashi Sakurai Atsushi Araki |
| author_facet | Yoshiaki Tamura Yoshiyuki Kimbara Takuya Yamaoka Ken Sato Yuki Tsuboi Remi Kodera Yuko Chiba Seijiro Mori Yoshinori Fujiwara Aya M. Tokumaru Hideki Ito Takashi Sakurai Atsushi Araki |
| author_sort | Yoshiaki Tamura |
| collection | DOAJ |
| description | Aims: Although evidence has accumulated that white matter hyperintensity (WMH) is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL), the clinical relevance of WMH in elderly patients with diabetes mellitus (DM) is not still clear. The aim of this study was to examine whether WMH volume is associated with ADL and cognitive function and whether glucose control and glucose variability can affect WMH volume in these patients.Methods: This cross-sectional study investigated the associations of WMH with cognitive function and instrumental ADL (IADL), as well as metabolic and vascular risk factors in a total of 178 elderly patients with diabetes. The study assessed WMH volumes and the functional status of cognition and IADL. WMH volumes were evaluated by obtaining axial T2-weighted and fluid-attenuated inversion recovery sequence images on brain magnetic resonance imaging and assessing the images using Software for Neuro-Image Processing in Experimental Research.Results: We found a significant association between WMH volumes and Mini-Mental State Examination (MMSE) scores (p = 0.039) and between WMH and IADL status (p = 0.006). Furthermore, we found significant relations of large WMH volumes with a high glycoalbumin/glycohemoglobin ratio (GA/HbA1c) (p < 0.001). Large WMH volumes were also found to be associated with a low body mass index (p = 0.014) and a low diastolic blood pressure (p = 0.024), but not with HbA1c. Multiple regression analysis showed that high GA/HbA1c, which reflects high glucose variability, was a significant determining factor for large WMH volumes. We also found that GA/HbA1c was negatively associated with both MMSE (p = 0.036) and IADL (p < 0.001).Conclusion: GA/HbA1c, which is a marker of glucose variability, was independently associated with WMH volumes, which could lead to the decline of cognition and IADL in elderly patients with DM. |
| first_indexed | 2024-04-13T14:10:55Z |
| format | Article |
| id | doaj.art-472189e9f2154e6b9aca4211a93233ce |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-04-13T14:10:55Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-472189e9f2154e6b9aca4211a93233ce2022-12-22T02:43:48ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652017-07-01910.3389/fnagi.2017.00220269047White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin RatioYoshiaki Tamura0Yoshiyuki Kimbara1Takuya Yamaoka2Ken Sato3Yuki Tsuboi4Remi Kodera5Yuko Chiba6Seijiro Mori7Yoshinori Fujiwara8Aya M. Tokumaru9Hideki Ito10Takashi Sakurai11Atsushi Araki12Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanResearch Team for Social Participation and Community Health, Tokyo Metropolitan Institute of GerontologyTokyo, JapanDepartment of Diagnostic Radiology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanCenter for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and GerontologyAichi, JapanDepartments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric HospitalTokyo, JapanAims: Although evidence has accumulated that white matter hyperintensity (WMH) is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL), the clinical relevance of WMH in elderly patients with diabetes mellitus (DM) is not still clear. The aim of this study was to examine whether WMH volume is associated with ADL and cognitive function and whether glucose control and glucose variability can affect WMH volume in these patients.Methods: This cross-sectional study investigated the associations of WMH with cognitive function and instrumental ADL (IADL), as well as metabolic and vascular risk factors in a total of 178 elderly patients with diabetes. The study assessed WMH volumes and the functional status of cognition and IADL. WMH volumes were evaluated by obtaining axial T2-weighted and fluid-attenuated inversion recovery sequence images on brain magnetic resonance imaging and assessing the images using Software for Neuro-Image Processing in Experimental Research.Results: We found a significant association between WMH volumes and Mini-Mental State Examination (MMSE) scores (p = 0.039) and between WMH and IADL status (p = 0.006). Furthermore, we found significant relations of large WMH volumes with a high glycoalbumin/glycohemoglobin ratio (GA/HbA1c) (p < 0.001). Large WMH volumes were also found to be associated with a low body mass index (p = 0.014) and a low diastolic blood pressure (p = 0.024), but not with HbA1c. Multiple regression analysis showed that high GA/HbA1c, which reflects high glucose variability, was a significant determining factor for large WMH volumes. We also found that GA/HbA1c was negatively associated with both MMSE (p = 0.036) and IADL (p < 0.001).Conclusion: GA/HbA1c, which is a marker of glucose variability, was independently associated with WMH volumes, which could lead to the decline of cognition and IADL in elderly patients with DM.http://journal.frontiersin.org/article/10.3389/fnagi.2017.00220/fullcognitive impairmentdiabetes mellitusglucose variabilityinstrumental activities of daily livingwhite matter hyperintensities |
| spellingShingle | Yoshiaki Tamura Yoshiyuki Kimbara Takuya Yamaoka Ken Sato Yuki Tsuboi Remi Kodera Yuko Chiba Seijiro Mori Yoshinori Fujiwara Aya M. Tokumaru Hideki Ito Takashi Sakurai Atsushi Araki White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio Frontiers in Aging Neuroscience cognitive impairment diabetes mellitus glucose variability instrumental activities of daily living white matter hyperintensities |
| title | White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio |
| title_full | White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio |
| title_fullStr | White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio |
| title_full_unstemmed | White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio |
| title_short | White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio |
| title_sort | white matter hyperintensity in elderly patients with diabetes mellitus is associated with cognitive impairment functional disability and a high glycoalbumin glycohemoglobin ratio |
| topic | cognitive impairment diabetes mellitus glucose variability instrumental activities of daily living white matter hyperintensities |
| url | http://journal.frontiersin.org/article/10.3389/fnagi.2017.00220/full |
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