Is there an association between leukoaraiosis volume and diabetes?

The relation between white matter loss (WML) and diabetes is still debated. The aim of this study was to investigate the correlation between typical WML- and diabetes-related magnetic resonance imaging (MRI) findings in a cohort of patients scheduled for carotid endarterectomy (CEA).

Ninety-three consecutive patients (mean age 71±9years; male 71) were included in a single-centre retrospective study. All the patients underwent MRI as baseline evaluation prior to CEA. A neuroradiologist blinded to the presence of risk factors calculated WML volume and number of lesions on FLAIR images using a semi-automated segmentation technique. Receiver operating characteristics analysis was performed to search for any association between WML volume and the number of WML lesions. The Mann-Whitney tests were used to determine significant WML differences between diabetic and non-diabetic patients. Logistic regression analysis was performed to evaluate the potential association of other variables.

The prevalence of diabetes was 20.4% (n=19). WML volume and number of WML lesions were significantly associated with diabetes (P=0.001). A statistically significant difference in WML volume was found between diabetic and non-diabetic patients (P<0.0001). Only diabetes, among all the investigated variables (WML volume, CAD status, age, smoking status, gender, hypertension, hyperlipidemia, diabetes) was significantly associated with WML (P=0.0001).

Our results demonstrate a strong statistical correlation between diabetes and WML. Future scientific challenges could include the identification of potential therapeutic targets and the creation of dedicated screening protocols for WML in diabetic patients other than the simple measurement of leukoaraiosis total burden.