Mediation analysis of brain magnetic resonance imaging variables with all-cause and cardiovascular disease-specific mortalities in persons with type 2 diabetes
- 23.10.2024
- Original Article
Erschienen in:
- Verfasst von
- Cheng-Chieh Lin
- Chia-Ing Li
- Chiu-Shong Liu
- Chih-Hsueh Lin
- Jiaxin Yu
- Shing-Yu Yang
- Tsai-Chung Li
- Erschienen in
- Acta Diabetologica | Ausgabe 5/2025
Abstract
Aim
Glucose variation (GV) has emerged as a predictor of morbidity and mortality in persons with diabetes. However, no study has examined whether brain magnetic resonance imaging (MRI) variables mediated the association between mortality and GV.
Materials and methods
This study was a retrospective cohort comprising 3,961 individuals with type 2 diabetes (T2D), whose electronic medical records were retrieved from a medical center between January 2001 and October 2021. GV was quantified using coefficient of variation of fasting plasma glucose (FPG-CV) and glycated hemoglobin (HbA1c). The MRI variables included the presence or absence of cerebrovascular abnormality and white matter hyperintensity (WMH). All deaths and deaths resulting from expanded cardiovascular disease (CVD) were identified through annual record linkage with National Death Datasets. Cox proportional hazards models were applied to evaluate associations of MRI variable or GV with mortality. Mediation analyses were performed to assess the relative contributions of MRI variables for GV on mortality.
Results
Among 3,961 patients, 2,114 patients (53.4%) had cerebrovascular abnormality and 1,888 patients (47.7%) had WMH. The results showed cerebrovascular abnormality and WMHs were significantly associated with all-cause and expanded CVD mortality after considering GV. The largest mediated effects of GV on all-cause and expanded CVD mortality were observed by cerebrovascular abnormality (5.26% and 8.49%, respectively).
Conclusions
Our study suggests cerebrovascular abnormality and WMHs are important predictors of mortality in patients with T2D after considering GV. In addition, MRI variables of cerebrovascular abnormality expressed weak but significant mediation effect on the associations between GV and mortality.
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- Titel
- Mediation analysis of brain magnetic resonance imaging variables with all-cause and cardiovascular disease-specific mortalities in persons with type 2 diabetes
- Verfasst von
-
Cheng-Chieh Lin
Chia-Ing Li
Chiu-Shong Liu
Chih-Hsueh Lin
Jiaxin Yu
Shing-Yu Yang
Tsai-Chung Li
- Publikationsdatum
- 23.10.2024
- Verlag
- Springer Milan
- Erschienen in
-
Acta Diabetologica / Ausgabe 5/2025
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233 - DOI
- https://doi.org/10.1007/s00592-024-02387-x
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