P150: Arterial Stiffness and Progression of Cerebral White Matter Lesions in asymptomatic Patients with Type 2 Diabetes and Matched Controls: A 5-Year Cohort Study

Abstract

Aim

Stroke is a frequent and feared complication in patients with type 2 diabetes. Arterial stiffness may improve current suboptimal risk prediction of stroke. However, studies in diabetes populations are lacking. We investigated the association between arterial stiffness progression (carotid-femoral pulse wave velocity [PWV]) and the progression of cerebral white matter lesions (WML), a marker of stroke risk, in patients with type 2 diabetes and matched controls.

Methods

In a 5-year follow-up study, data from 49 patients and 58 controls were available for analysis. At baseline, participants had a mean (±SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (1.0–3.2) years. Fifty-two (49%) were males. At both baseline and follow-up, PWV was obtained by tonometry and WML by cerebral T2-FLAIR MRI. WML was assessed by Breteler score, and progression was defined as an upward change in category during follow-up.

Results

Patients with type 2 diabetes had a higher PWV than controls at both baseline (9.2 ± 2.2 vs. 7.9 ± 1.4m/s, p<0.01) and follow-up (9.8 ± 2.4 vs. 8.6 ± 1.9m/s, p = 0.01). Breteler scores and WML progression were similar in the two groups (p>0.05). PWV progression was associated with WML progression in the total cohort (adjusted for age, sex, diabetes, baseline PWV and systolic blood pressure progression: OR 1.58 [95%CI: 1.09–2.28], p = 0.02). We found no interaction between diabetes and PWV progression on WML progression.

Conclusions

PWV progression is associated with WML progression in patients with type 2 diabetes and healthy controls. PWV candidates as a new risk marker for stroke.