Risk Factor Analysis of Severe Cerebral White Matter Hyperintensities in Type 2 Diabetes Patients: A Retrospective Single-Center Observational Study

Abstract

Background: Bone is recently confirmed to be an endocrine organ, and may influence the neuron, leading to the cognitive decline and emotional disorder. However, the interaction between bone and cerebral white matter hyperintensities (WMH) is still unclarified in type 2 diabetes patients. Methods: WMH was quantified on magnetic resonance imaging (MRI) using the Fazekas and Schmidt's scoring protocol. Patients with scores ranging from 0 to 1 were defined as none or mild WMH (Group 1), and patients with scores ranging from 2 to 3 as severe WMH (Group 2). Logistic regression analysis was done to determine the association between WMH severity and selected clinical factors. Findings: Of the 194 subjects who were included in the study, there were significant differences among the two groups with respect to age and osteocalcin. After adjustment for possible confounders, age (odds ratio (OR): 1.07; 95% confidence interval (CI): 1.04-1.12; P < 0.001) and low density lipoprotein (OR: 1.51; 95% CI: 1.09-2.08; P =0.012) were associated with severe WMH, while osteocalcin could decrease the severity of WMH (OR: 0.96; 95% CI: 0.84-0.98; P =0.014). Interpretation: Our data indicate that aging, lower osteocalcin and higher LDL are associated with severe WMH in type 2 diabetes patients. The mechanism of the relationship between osteocalcin and WMH needs further research. Funding Statement: This work was supported by General Scientific Research Project of Zhejiang Education Department (Y201838964), Project of medicine and health technology program in Zhejiang province (2019314900). Declaration of Interests: All authors declare that they have no conflict of interest. Ethics Approval Statement: Ethics approval was obtained from the Ethics Board of Shanghai Tenth People’s Hospital.