{"id":2926,"date":"2021-02-24T11:04:22","date_gmt":"2021-02-24T15:04:22","guid":{"rendered":"https:\/\/www.atlanticpath.ca\/?p=2926"},"modified":"2021-02-24T11:04:22","modified_gmt":"2021-02-24T15:04:22","slug":"diabetes-brain-infarcts-cognition-and-small-vessels-in-the-canadian-alliance-for-healthy-hearts-and-minds-study","status":"publish","type":"post","link":"https:\/\/www.atlanticpath.ca\/index.php\/2021\/02\/24\/diabetes-brain-infarcts-cognition-and-small-vessels-in-the-canadian-alliance-for-healthy-hearts-and-minds-study\/","title":{"rendered":"Diabetes, Brain Infarcts, Cognition, and Small Vessels in the Canadian Alliance for Healthy Hearts and Minds Study"},"content":{"rendered":"

Journal: The Journal of Clinical Endocrinology & Metabolism<\/em><\/p>\n

Authors: <\/em>Hertzel C Gerstein,\u00a0Eric E Smith,\u00a0Chinthanie Ramasundarahettige,\u00a0Dipika Desai,\u00a0Philip Awadalla,\u00a0Philippe Broet,\u00a0Sandra Black,\u00a0Trevor J B Dummer,\u00a0Jason Hicks,\u00a0Alan Moody,\u00a0Jean-Claude Tardif,\u00a0Koon K Teo,\u00a0Jennifer Vena,\u00a0Salim Yusuf,\u00a0Douglas S Lee,\u00a0Matthias G Friedrich,\u00a0Sonia S Anand<\/p>\n

Abstract:<\/p>\n

Background<\/strong><\/p>\n

Diabetes is a risk factor for cerebrovascular disease and cognitive impairment. The anatomical basis for this is uncertain.<\/p>\n

Methods<\/strong><\/p>\n

The Canadian Alliance for Healthy Hearts and Minds collected brain and carotid magnetic resonance imaging (MRI) and 2 cognitive tests (the Digit Symbol Substitution Test and the Montreal Cognitive Assessment test) in a cross-sectional sample of men and women. Brain MRIs identified brain infarcts (BI), lacunar BI, high white matter hyperintensity (WMH), vascular brain injury (VBI; BI or high WMH), and small vessel VBI (lacunar BI or high WMH). Carotid MRIs estimated carotid wall volume, a measure of subclinical atherosclerosis. Cognitive scores were standardized to each site\u2019s mean score, and cognitive impairment was identified by 1 or both test scores \u22641 standard deviation below the site\u2019s mean score on that test.<\/p>\n

Results<\/strong><\/p>\n

The 7733 participants included 495 participants (6.4%) with diabetes, of whom 388 were taking diabetes drugs. After age and sex adjustment, diabetes was independently associated with BI (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.05, 2.24), VBI (OR 1.64, 95% CI 1.26, 2.13), small vessel VBI (OR 1.67, 95% CI 1.28, 2.19), and cognitive impairment (OR 1.47, 95% CI 1.20, 1.80). The association between diabetes and small vessel VBI persisted after adjustment for cerebrovascular disease risk factors and nonlacunar infarcts (OR 1.52, 95% CI 1.15, 2.01), and the association with cognitive impairment persisted after adjustment for small vessel VBI (OR 1.27, 95% CI 1.03, 1.56).<\/p>\n

Conclusion<\/strong><\/p>\n

Small vessel disease characterizes much of the relationship between diabetes and VBI. However, additional factors are required to disentangle the relationship between diabetes and cognitive impairment.<\/p>\n

Link: https:\/\/doi.org\/10.1210\/clinem\/dgaa815<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Journal: The Journal of Clinical Endocrinology & Metabolism Authors: Hertzel C Gerstein,\u00a0Eric E Smith,\u00a0Chinthanie Ramasundarahettige,\u00a0Dipika Desai,\u00a0Philip Awadalla,\u00a0Philippe Broet,\u00a0Sandra Black,\u00a0Trevor J B Dummer,\u00a0Jason Hicks,\u00a0Alan Moody,\u00a0Jean-Claude Tardif,\u00a0Koon K Teo,\u00a0Jennifer Vena,\u00a0Salim Yusuf,\u00a0Douglas S Lee,\u00a0Matthias G Friedrich,\u00a0Sonia S Anand Abstract: Background Diabetes is a risk factor for cerebrovascular disease and cognitive impairment. The anatomical basis for this is uncertain. Methods The Canadian Alliance for Healthy Hearts and Minds collected brain and carotid magnetic resonance imaging (MRI) and 2 cognitive tests (the Digit Symbol Substitution Test and the Montreal Cognitive Assessment test) in a cross-sectional sample of men and women. Brain MRIs identified brain infarcts (BI), lacunar BI, high white matter hyperintensity (WMH), vascular brain injury (VBI; BI or high WMH), and small vessel VBI (lacunar BI or high WMH). Carotid MRIs estimated carotid wall volume, a measure of subclinical atherosclerosis. Cognitive scores were standardized to each site\u2019s mean score, and cognitive impairment was identified by 1 or both test scores \u22641 standard deviation below the site\u2019s mean score on that test. Results The 7733 participants included 495 participants (6.4%) with diabetes, of whom 388 were taking diabetes drugs. After age and sex adjustment, diabetes was independently associated with BI (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.05, 2.24), VBI (OR 1.64, 95% CI 1.26, 2.13), small vessel VBI (OR 1.67, 95% CI 1.28, 2.19), and cognitive impairment (OR 1.47, 95% CI 1.20, 1.80). The association between diabetes and small vessel VBI persisted after adjustment for cerebrovascular disease risk factors and nonlacunar infarcts (OR 1.52, 95% CI 1.15, 2.01), and the association with cognitive impairment persisted after adjustment for small vessel VBI (OR 1.27, 95% CI 1.03, 1.56). Conclusion Small vessel disease characterizes much of the relationship between diabetes and VBI. However, additional factors are required to disentangle the relationship between diabetes and cognitive impairment. Link: https:\/\/doi.org\/10.1210\/clinem\/dgaa815<\/p>\n","protected":false},"author":1,"featured_media":2927,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_eb_attr":"","_lmt_disableupdate":"","_lmt_disable":"","footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"today","timeOption":"now","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":"absolute"},"_wpsp_active_default_template":true},"categories":[4],"tags":[],"class_list":["post-2926","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publications"],"acf":[],"modified_by":"pathwp","_links":{"self":[{"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/posts\/2926","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/comments?post=2926"}],"version-history":[{"count":2,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/posts\/2926\/revisions"}],"predecessor-version":[{"id":2929,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/posts\/2926\/revisions\/2929"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/media\/2927"}],"wp:attachment":[{"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/media?parent=2926"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/categories?post=2926"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.atlanticpath.ca\/index.php\/wp-json\/wp\/v2\/tags?post=2926"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}