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Influence of chronic hyperglycemia on cerebral microvascular remodeling: an in vivo study using perfusion computed
Qinghua Hou1, Zhiyi Zuo, Patrik Michel
1From the Neuroradiology Division, Department of Radiology (Q.H., Y.Z., F.M., M.W.), Department of Anesthesiology (Z.Z.), and Department of Neurology (K.C.J.), University of Virginia, Charlottesville, VA; Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, China (Q.H., Q.G.); Department of Neurology (P.M., A.E.), and Department of Radiology (M.W.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Ultrasound, the Union Hospital of Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China (Y.Z.); and Department of Radiology, the Tongren Hospital of Capital Medical University, Beijing, China (F.M.).
Insights
Chronic hyperglycemia, indicated by elevated hemoglobin A1c (HbA1c), may be linked to changes in brain blood vessels. This study found longer mean transit times in the brains of patients with higher HbA1c levels.
Area of Science:
- Neuroscience
- Endocrinology
- Radiology
Background:
- Chronic hyperglycemia is a hallmark of diabetes mellitus.
- Cerebrovascular complications are common in diabetic patients.
- Microvascular remodeling can affect brain function.
Purpose of the Study:
- To investigate the impact of chronic hyperglycemia on cerebral microvascular remodeling.
- To utilize perfusion computed tomography (CT) for assessing microvascular changes.
- To correlate glycemic control with cerebral perfusion parameters.
Main Methods:
- Retrospective analysis of 26 patients undergoing perfusion CT.
- Patients categorized by hemoglobin A1c (HbA1c) levels (>6.5% vs. ≤6.5%).
- Perfusion CT data analyzed using deconvolution software to determine mean transit time (MTT).
Main Results:
- Significantly longer MTT observed in the nonischemic cerebral hemisphere for patients with HbA1c >6.5%.
- This effect was particularly pronounced in white matter (P=0.005).
- A significant positive correlation was found between MTT and HbA1c levels (R=0.469, P=0.016).
Conclusions:
- Findings suggest a potential association between chronic hyperglycemia and cerebral microvascular remodeling in humans.
- Elevated HbA1c levels may indicate alterations in cerebral capillary architecture.
- Further prospective studies with larger cohorts are needed for confirmation.
Background And Purpose:
To investigate the effect of chronic hyperglycemia on cerebral microvascular remodeling using perfusion computed tomography.
Methods:
We retrospectively identified 26 patients from our registry of 2453 patients who underwent a perfusion computed tomographic study and had their hemoglobin A1c (HbA1c) measured. These 26 patients were divided into 2 groups: those with HbA1c>6.5% (n=15) and those with HbA1c≤6.5% (n=11). Perfusion computed tomographic studies were processed using a delay-corrected, deconvolution-based software. Perfusion computed tomographic values were compared between the 2 patient groups, including mean transit time, which relates to the cerebral capillary architecture and length.
Results:
Mean transit time values in the nonischemic cerebral hemisphere were significantly longer in the patients with HbA1c>6.5% (P=0.033), especially in the white matter (P=0.005). Significant correlation (R=0.469; P=0.016) between mean transit time and HbA1c level was observed.
Conclusions:
Our results from a small sample suggest that chronic hyperglycemia may be associated with cerebral microvascular remodeling in humans. Additional prospective studies with larger sample size are required to confirm this observation.
