Correlation between Cerebral Perfusion and Retinal Oxygenation Response of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Yu-xing XIONG; Jun TANG; Ru-yun LIN; Jia-min NIE; Min-jie ZHOU; Ju-wei SHAO

doi:10.12259/j.issn.2095-610X.S20211046

Volume 42 Issue 10

Oct. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2021 > 42(10): 76-83

Yu-xing XIONG, Jun TANG, Ru-yun LIN, Jia-min NIE, Min-jie ZHOU, Ju-wei SHAO. Correlation between Cerebral Perfusion and Retinal Oxygenation Response of Diabetic Retinopathy in Type 2 Diabetes Mellitus[J]. Journal of Kunming Medical University, 2021, 42(10): 76-83. doi: 10.12259/j.issn.2095-610X.S20211046

Citation:

Yu-xing XIONG, Jun TANG, Ru-yun LIN, Jia-min NIE, Min-jie ZHOU, Ju-wei SHAO. Correlation between Cerebral Perfusion and Retinal Oxygenation Response of Diabetic Retinopathy in Type 2 Diabetes Mellitus[J]. Journal of Kunming Medical University, 2021, 42(10): 76-83. doi: 10.12259/j.issn.2095-610X.S20211046

Citation:

Yu-xing XIONG, Jun TANG, Ru-yun LIN, Jia-min NIE, Min-jie ZHOU, Ju-wei SHAO. Correlation between Cerebral Perfusion and Retinal Oxygenation Response of Diabetic Retinopathy in Type 2 Diabetes Mellitus[J]. Journal of Kunming Medical University, 2021, 42(10): 76-83. doi: 10.12259/j.issn.2095-610X.S20211046

PDF( 769 KB)

Correlation between Cerebral Perfusion and Retinal Oxygenation Response of Diabetic Retinopathy in Type 2 Diabetes Mellitus

doi: 10.12259/j.issn.2095-610X.S20211046

1.
The Endocrinology Department of the Affiliated Hospital of Yunnan University （The Second People Hospital of Yunnan Province），Kunming Yunnan 650021
2.
Community Healthcare Center of Chengjiang fenglu street，Chengjiang Yunnan 653100
3.
Quality Control Department of the Affiliated Hospital of Yunnan University （The Second People Hospital of Yunnan Province），Kunming Yunnan 650021
4.
The Radiology Department of the Affiliated Hospital of Yunnan University （The Second People Hospital of Yunnan Province），Kunming Yunnan 650021，China

Received Date: 2021-08-11
Publish Date: 2021-10-25

Abstract

Abstract

Objective To study MR cerebral perfusion and the retinal oxygenation response in patients with different stages of diabetic retinopathy without hypertension and normal control group, and to analyze the correlation between different cerebral perfusion parameters and retinal oxygenation response. Methods From June 2017 to December 2019, 34 patients with diagnosed type 2 diabetes mellitus （T2DM） and 21 healthy controls were enrolled in the Department of Endocrinology and ophthalmology department, the Affiliated Hospital of Yunnan University. T2DM patients were divided into proliferative stage of diabetic retinopathy （PDR） group and non-diabetic retinopathy （NDR） group according to ophthalmofundoscopy. All subjects with hypertension were excluded. Plain MR, magnetic resonance angiography （MRA）, dynamic susceptibility contrast-perfusion weighted imaging （DSC-PWI）, orbital 3D-spoiled GRASS （3D-SPGR） before and after oxygen uptake scans were performed. Continuous variables were analyzed by unpaired t-test. Pearson product moment correlation was performed between relative cerebral blood flow （rCBF） and variables of retinal delta PO_（2）（△P0₂） in bilateral temporal, nasal and optic disc of eyeballs of PDR and NDR group. Results rCBF of left inferior temporal gyrus and bilateral cingulate gyrus in PDR group was lower than that in NDR group and NC group （P < 0.05）. Relative cerebral blood volume （rCBV） of right inferior temporal gyrus, left occipital lobe and left cingulate gyrus in PDR group was lower than that in NDR group and NC group （ P < 0.05）, and the rCBV of right parahippocampal gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）. The mean transit time （MTT） of left inferior temporal gyrus, left cerebellar hemisphere and bilateral middle frontal gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）. The mean transit time of left parahippocampal gyrus and right pons in PDR group was lower than that in NDR group and NC group （ P < 0.05）. Time to peak （TTP） of left cerebellar hemisphere, bilateral middle frontal gyrus, left inferior temporal gyrus and right cingulate gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）, and TTP of right pontine and right parahippocampal gyrus in PDR group was lower than that in NDR and NC group （ P < 0.05）. The difference of △ P0 ₂ in bilateral temporal, nasal and optic disc of eyeballs between PDR group, NDR group and NC group was statistically significant （P < 0.05）. rCBF of left inferior temporal gyrus and bilateral cingulate gyrus in PDR group and NDR group were correlated with △P0 ₂ of bilateral temporal, nasal and optic disc （P < 0.05）. Conclusions There was significant association between cerebral blood flow perfusion and the diabetic retinopathy （DR） severity in type 2 diabetes mellitus. MRI retinal oxygenation response can be used as an imaging marker of diabetic cerebral capillary disease.
- Type 2 Diabetes Mellitus,
- Diabetic retinopathy,
- Cerebral blood perfusion,
- Retinal oxygenation response

FullText(HTML)

References(33)

References

[1]	Chatterjee S,Khunti K,Davies M J. Type 2 diabetes[J]. Lancet,2017,389:2239-2251. doi: 10.1016/S0140-6736(17)30058-2
[2]	International Diabetes Federation. International Diabetes Federation Diabetes Atlas 9th edition, Brussels: The Institute; 2019. （https;//www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf）
[3]	Zhou H,Zhang X,Lu J. Progress on diabetic cerebrovascular diseases[J]. Bosn J Basic Med Sci,2014,14(4):185-90. doi: 10.17305/bjbms.2014.4.203
[4]	乐小婧,陈婕,张帆,等. 代谢综合征与2型糖尿病的相关研究进展[J]. 昆明医科大学学报,2020,41(5):145-149. doi: 10.3969/j.issn.1003-4706.2020.05.028
[5]	Teo Z L,Tham Y C,Yan Yu M C,et al. Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045:Systematic Review and Meta-analysis[J]. Ophthalmology,2021,30:S0161.
[6]	Cheung N,Mitchell P,Wong T Y. Diabetic Retinopathy[J]. Lancet,2010,376:124-136. doi: 10.1016/S0140-6736(09)62124-3
[7]	Wang Z,Lu Z,Li J,et al. Evaluation of apparent diffusion coefficient measurements of brain injury in type 2 diabetics with retinopathy by diffusion-weighted MRI at 3.0 T[J]. Neuroreport,2017,28(2):69-74. doi: 10.1097/WNR.0000000000000703
[8]	Liang M,Chen X,Xue F,et al. Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy[J]. Exp Ther Med,2017,14(2):1153-1156. doi: 10.3892/etm.2017.4582
[9]	Yang Y,Yang Y,Wu X,et al. Adding DSC PWI and DWI to BT-RADS can help identify postoperative recurrence in patients with high-grade gliomas[J]. J Neurooncol.,2020,146(2):363-371. doi: 10.1007/s11060-019-03387-6
[10]	Lee H,Jung K,Kang D W,et al. Fully Automated and Real-Time Volumetric Measurement of Infarct Core and Penumbra in Diffusion- and Perfusion-Weighted MRI of Patients with Hyper-Acute Stroke[J]. J Digit Imaging,2020,33(1):262-272. doi: 10.1007/s10278-019-00222-2
[11]	Amukotuwa S A,Fischbein N J,Albers G W,et al. Comparison of T2*GRE and DSC-PWI for hemorrhage detection in acute ischemic stroke patients:Pooled analysis of the EPITHET,DEFUSE 2,and SENSE 3 stroke studies[J]. Int J Stroke,2020,15(2):216-225. doi: 10.1177/1747493019858781
[12]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志,2018,10(1):4-67. doi: 10.3760/cma.j.issn.1674-5809.2018.01.003
[13]	中国高血压防治指南修订委员会等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56. doi: 10.3969/j.issn.1007-5410.2019.01.002
[14]	Trick G L,Edwards P,Desai U,et al. Early supernormal retinal oxygenation response in patients with diabetes[J]. Investigative Ophthalmology & Visual Science,2006,47(4):1612-1619.
[15]	Do D V,Wang X,Vedula S S,et al. Blood pressure control for diabetic retinopathy[J]. Sao Paulo Medical Journal,2015,133(3):278-279. doi: 10.1590/1516-3180.20151333T1
[16]	许庆刚,陈青华,杨庆松,等. 糖尿病患者视网膜氧合反应的磁共振研究[J]. 眼科,2009,18(5):323-327.
[17]	邱建博,陈广浩,黄红涛,等. 磁共振灌注成像在卒中后早期新发病灶中的预测价值[J]. 临床放射学杂志,2019,38(11):2037-2041.
[18]	Sanahuja J,Alonso N,Diez J,et al. Increased Burden of Cerebral Small Vessel Disease in Patients with Type 2 Diabetes and Retinopathy[J]. Diabetes Care,2016,39(9):1614-1620. doi: 10.2337/dc15-2671
[19]	Heni M,Wagner R,Kullmann S,et al. Response to Comment on Heni et al. Central Insulin Administration Improves Whole-Body Insulin Sensitivity via Hypothalamus and Parasympathetic Outputs in Men[J]. Diabetes,2015,64(6):e8-e9. doi: 10.2337/db15-0209
[20]	Hou-guang zhou,Dong Jiang,ren-ming hu. The research progress of diabetic cerebrovascular disease[J]. Chinese Journal of Cerebrovascular Disease,2009,6(1):49-53.
[21]	Tanaka S,Tanaka S,Iimuro S,et al. Predicting Macro-and Microvascular Complications in Type 2 Diabetes:The Japan Diabetes Complications Study/the Japanese Elderly Diabetes Intervention Trial risk engine[J]. Diabetes Care,2013,36(5):1193-1199. doi: 10.2337/dc12-0958
[22]	Liu Q,Wang S,Cai L. Diabetic cardiomyopathy and its mechanisms:role of oxidative stress and damage[J]. J Diabetes Investig,2014,5:634.
[23]	Zlatar Z Z,Wierenga C E,Bangen K J,et al. Increased hippocampal blood flow in sedentary older adults at genetic risk for Alzheimer's disease[J]. J Alzheimers Dis,2014,41(3):809-817. doi: 10.3233/JAD-132252
[24]	Filas B A,Shui Y B,Beebe D C. Computational Model for Oxygen Transport and Consumption in Human Vitreous[J]. Investigative Opthalmology & Visual Science,2013,54(10):6549.
[25]	Luan H,Leitges M,Gupta R R,et al. Effect of PKCbeta on retinal oxygenation response in experimental diabetes[J]. Invest Ophthalmol Vis Sci,2004,45(3):937-942. doi: 10.1167/iovs.03-1007
[26]	Trick G L,Edwards P A,Desai U,et al. MRI retinovascular studies in humans:research in patients with diabetes[J]. NMR Biomed,2008,21(9):1003-1012. doi: 10.1002/nbm.1314
[27]	Linsenmeier R A,Zhang H F. Retinal oxygen:from animals to humans[J]. Prog Retin Eye Res,2017,58:115-151. doi: 10.1016/j.preteyeres.2017.01.003
[28]	Umemura T,Kawamura T,Hotta N. Pathogenesis and neuroimaging of cerebral large and small vessel disease in type 2 diabetes:A possible link between cerebral and retinal microvascular abnormalities[J]. J Diabetes Investig,2017,8(2):134-148. doi: 10.1111/jdi.12545
[29]	黄宽宽,黄珊,恽文伟,等. 轻型卒中患者脑小血管病总负荷与视网膜血管直径的相关性[J]. 中华医学杂志,2021,101(1):62-67. doi: 10.3760/cma.j.cn112137-20200405-01088
[30]	Wardlaw J M,Doubal F,Armitage P,et al. Lacunar stroke is associated with diffuse blood-brain barrier dysfunction[J]. Ann Neurol,2009,65(2):194-202. doi: 10.1002/ana.21549
[31]	Doubal F N,Hokke P E,Wardlaw J M. Retinal microvascular abnormalities and stroke:a systematic review[J]. J Neurol Neurosurg Psychiatry,2009,80:158-165. doi: 10.1136/jnnp.2008.153460
[32]	Lindley R I,Wang J J,Wong M C,et al. Retinal microvasculature in acute lacunar stroke:a cross-sectional study[J]. Lancet Neurol,2009,8:628-634. doi: 10.1016/S1474-4422(09)70131-0
[33]	Naruse K,Nakamura J,Hamada Y,et al. Aldose reductase inhibition prevents glucose-induced apoptosis in cultured bovine retinal microvascular pericytes[J]. Exp Eye Res,2000,71(3):309-315. doi: 10.1006/exer.2000.0882

Relative Articles(20)

Relative Articles

[1]	Yanzhen ZHANG, Li SHI, Lingyan YUAN, Hongying NIU, Peixin TIAN, Yushan XU. Discriminative Performance of the Combined MoCA/MMSE and NPAR for Type 2 Diabetes Mellitus-related Peripheral Neuropathy. Journal of Kunming Medical University, 2026, 48(): 1-15.
[2]	Abudourexiti GULISITAN, Feng ZHANG. Correlation Between Intestinal Flora，Serum sdLDL-C，LPS，and Diabetic Retinopathy. Journal of Kunming Medical University, 2026, 47(6): 76-83. doi: 10.12259/j.issn.2095-610X.S20260608
[3]	Pei LI, Jing ZHOU, Jiaqin CHEN. EGFL7 Inhibits the Sestrin2/Nrf2 Signaling Pathway，promotes Angiogenesis，and aggravates Diabetic Retinopathy in Rats. Journal of Kunming Medical University, 2026, 47(1): 39-46. doi: 10.12259/j.issn.2095-610X.S20260105
[4]	Chunhui ZHANG, Long YANG, Xu ZHA, Liqiong ZHOU, Quan CHENG, Yuanping ZHANG. Correlation Between Metabolic Syndrome and Diabetic Retinopathy. Journal of Kunming Medical University, 2026, 47(2): 101-114. doi: 10.12259/j.issn.2095-610X.S20260211
[5]	Nan HUO, Junbo ZHAO, Min WANG, Weiqiao AN, Cui CUI. The Relationship between M1/M2 Macrophage Expression and the Severity of Diabetes Retinopathy. Journal of Kunming Medical University, 2025, 46(11): 100-106. doi: 10.12259/j.issn.2095-610X.S20251113
[6]	Enxian ZHU, Ben NIU, Lina TIAN, Yajuan XIE. Risk Factor Analysis of Type 2 Diabetic Peripheral Neuropathy Complicated with Microangiopathy. Journal of Kunming Medical University, 2024, 45(8): 44-51. doi: 10.12259/j.issn.2095-610X.S20240807
[7]	Siqi WU, Gang CHEN, Yishuang XIAO. Effect of Comprehensive Treatment for Aggressive Retinopathy of Prematurity. Journal of Kunming Medical University, 2022, 43(5): 127-132. doi: 10.12259/j.issn.2095-610X.S20220513
[8]	Wang Jin Rui , Yang Ying . . Journal of Kunming Medical University, 2019, 40(04): 131-135.
[9]	Shen Zhi Xiang , Zhu Li Xun , Xu Wei Hong . 有氧运动对2型糖尿病大鼠AGE-RAGE轴及NF-κB通路的影响. Journal of Kunming Medical University, 2018, 39(01): 16-19.
[10]	Lei Huo . The Current Situation of the Prevention and Treatment of Diabetic Eye Disease in Yunnan Province. Journal of Kunming Medical University,
[11]	Bian Hai Xia . . Journal of Kunming Medical University,
[12]	Qin Min Li . . Journal of Kunming Medical University,
[13]	Du Juan . . Journal of Kunming Medical University,
[14]	Zhu Zhao . . Journal of Kunming Medical University,
[15]	Tang Li Li . . Journal of Kunming Medical University,
[16]	Cha Xue Ping . . Journal of Kunming Medical University,
[17]	. Effects of Exercise Training on Glucose Intolerance in Rats with Type 2 Diabetes Induced by Alloxan. Journal of Kunming Medical University,
[18]	. The Relationship between Glycated Hemoglobin and Diabetic Retinopathy. Journal of Kunming Medical University,
[19]	Xu Yu Shan . . Journal of Kunming Medical University,
[20]	Li Guo Dong . . Journal of Kunming Medical University,