Influence of cerebral small vessel disease on functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.

XU, Huiwei; ZHANG, Song; XU, Juan; YUAN, Binbin; SONG, Huangcheng

Objective: To estimate the effect of the total cerebral small vessel disease score in the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes. Methods: A comparative study was used to review the initial cerebral infarction cases of patients with type 2 diabetes undergoing cranial MRI during 2016–2019, follow up their recovery for 3 months, and count the events of cerebral infarction recurrence within 24 months. MRI with lacunes, enlarged perivascular space (EPVS), cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) were defined as cerebral small vessel disease (CSVD). Chi-square tests, t-tests, rank-sum tests, and Logistic regression were used for the statistical analysis. Results: A total of 208 patients were included in the analyses. Mean age was 65.2 ± 11.8 years, and 62% were men. The distribution of the total SVD score from 0 to 4 was 26.9%, 23.6%, 26.4%, 16.3%, and 6.7%. Multivariate Logistic regression showed that the cumulative CSVD score was independently associated with poor outcome 3 months after cerebral infarction (OR:2.193, 95% CI:1.673–2.875) and recurrence within 2 years (OR:2.715, 95% CI: 1.363–2.979). Lacunes, CMBs, WMHs but not EPVS were associated with the modified Rankin Scale (mRS) scores at 3 months after cerebral infarction, Lacunes was associated with recurrence within 2 years. However, the impact of each CSVD marker on functional outcome and stroke recurrence was smaller than that of the total CSVD score. Conclusion: Cumulative CSVD burden exert important influences on the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.

RISK assessment; T-test (Statistics); FUNCTIONAL assessment; MULTIPLE regression analysis; MAGNETIC resonance imaging; CHI-squared test; MANN Whitney U Test; DESCRIPTIVE statistics; ODDS ratio; TYPE 2 diabetes; CEREBRAL small vessel diseases; WHITE matter (Nerve tissue); CONVALESCENCE; CEREBRAL infarction; DISEASE relapse; COMPARATIVE studies; CONFIDENCE intervals; CEREBRAL hemorrhage; DISEASE risk factors

International Journal of Diabetes in Developing Countries, 2024, Vol 44, Issue 4, p732

0973-3930

Academic Journal

10.1007/s13410-023-01281-6