Association between Diabetes Mellitus (DM) and Leukoaraiosis: A Pilot Study (P04.061)

OBJECTIVE: To determine the relationship between DM and leukoaraiosis among patients who had experienced an acute ischemic stroke. BACKGROUND: With the widespread use of CT and MRI scans of the brain, areas of altered signal intensity are frequently identified in the cerebral hemispheric sub-cortical and periventricular white matter. In severe cases, the lesions become confluent and this radiological feature is termed leukoaraiosis. Initially leukoaraiosis was considered to be of little, if any, clinical significance. However accumulating evidence from population-based studies have shown that progression of leukoaraiosis was associated with increased risk of clinical stroke, cognitive decline, and dementia. Several risk factors for leukoaraiosis have been identified, with increasing age and hypertension been the most potent risk factors. A treatable condition thought to be associated with leukoaraiosis is DM but the relationship is not established. DESIGN/METHODS: We studied 50 individuals with acute stroke 25 with and 25 without DM. Both groups were matched for age and hypertension. For each subject, the presence or absence of leukoaraiosis in the hemisphere that is not involved in the index stroke was documented. When present, the severity of leukoaraiosis was scored using the scale proposed by Manolio etal. Student t-test was used to compare the mean of the severity grades of the two groups. The significance level was set at p = 0.05. For comparison of the other baseline variables, student t-test was used for continuous and Χ2 test for categorical variables. RESULTS: We observed statistically significant (p=0.007) difference in the prevalence and severity of leukoaraiosis in the group with DM when compared to the control group. CONCLUSIONS: Our results indicate that, among patients who had an acute stroke, there is an association between leukoaraiosis and DM. Leukoaraiosis was more prevalent and more severe among the diabetic subjects compared to non-diabetic subjects. Disclosure: Dr. Perera has nothing to disclose. Dr. Chan has received personal compensation in an editorial capacity for the Stroke journal. Dr. Lee has nothing to disclose.