Correlation Between Carotid Arteriosclerosis And Severity Of Cerebral White Matter Lesions In Type 2 Diabetes Patients

Objective: The prevalence of Type 2 Diabetes Mellitus(T2DM)has been increasing in recent years and chronic high glucose environments can damage blood vessels through oxidative stress,and carotid atherosclerosis(CAS)has been associated with ischaemic stroke.In recent studies,T2 DM has been found to increase the risk of cognitive impairment,and head imaging in this group of patients shows a greater volume of high signal in the white matter of the brain.This study investigates the risk factors for white matter lesion(WML)in patients with T2 DM,and examines the relationship between CAS and WML severity in patients with type 2 diabetes to provide a basis for preventing and treating the development and progression of WML in patients with T2 DM.Methods: 1,134 clinical data of inpatients in the Department of Endocrinology of Jilin Provincial People’s Hospital from April 2020 to November 2022 were included for retrospective analysis.2,Based on head MRI,they were divided into WML group(n=67)and no WML group(n=67).3,The patients’ gender,age,body mass index(Body mass index(BMI),previous history of hypertension,coronary heart disease and history of smoking and alcohol consumption,blood biochemical indices related to diabetes mellitus,and carotid artery ultrasound to assess carotid atherosclerosis in both groups for comparison between groups.4.In the WML group,paraventricular and deep white matter lesions were scored according to the Fazekas scale and classified as mild to moderate(n=41)and severe(n=26).Finally,statistically significant variables were subjected to logistic regression analysis to further analysis the risk factors associated with the development of WML in T2 DM and its severity.Results: 1,Among type 2 diabetic patients,the WML group had higher levels of age,duration of disease,FPG,and Hb A1 C.Their hypertension and CAS ratio was higher(p<0.05).2.The CAS group(n=79)had a WML presence rate of 58.22%(46 cases),a mild to moderate WML rate of 27.8%(22 cases)and a severe WML variant rate of 30.37%(24 cases),which was higher than the N-CAS group(n=55)with a WML presence rate of 38.18%(21 cases),a mild to moderate WML rate of 34.54%(19 cases)and severe WML rate of 3.63%(2 cases),with statistically significant differences(z=3.168,p<0.05).3.Spearman’s grade correlation analysis showed that WML grade was associated with age(r=0.326),FPG(r=0.285),Hb A1c(r=0.253),carotid atherosclerosis degree(r=0.357)were positively correlated,all P<0.05.4.Multi-factors logistic regression analysis showed that age,Hb A1 c,and CAS were risk factors for the severity of cerebral white matter lesions in type 2 diabetic patients.Conclusion: 1.the severity of WML in T2 DM patients was positively correlated with CAS;2.age was an independent influence on the prevalence and progression of WML in T2 DM patients.patients with T2 DM combined with CAS or elevated Hb A1 c were more likely to have severe WML;3.hypertension,duration of diabetes,and glycemic control affected the occurrence of WML in T2 DM patients.