Aorticstiffness isassociated withwhitematter integrityinpatients with type 1 diabetes

Objective Toassesstheassociationbetween aorticpulse wave velocity (PWV) as a marker of arterial stiffness and diffusion tensor imaging of brain white matter integrity in patients with type 1 diabetes using advanced magnetic resonance imaging (MRI) technology. Methods Forty-one patients with type 1 diabetes (23 men, mean age 44±12 years, mean diabetes duration 24±13 years) wereincluded. AorticPWV was assessedusing through-plane velocity-encoded MRI. Brain diffusion tensor imaging (DTI) measurements were performed on 3-T MRI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated for white and grey matter integrity. Pearson correlation and multivariable linear regression analyses including cardiovascular risk factors as covariates were assessed. Results Multivariable linear regression analyses revealed that aortic PWV is independently associated with white matter integrity FA (β=�0.777, p=0.008) in patients with type 1 diabetes. This effect was independent of age, gender, mean arterial pressure, body mass index, smoking, duration of diabetes and glycated haemoglobin levels. Aortic PWV was not significantly related to grey matter integrity. Conclusions Our data suggest that aortic stiffness is independently associated with reduced white matter integrity in patients with type 1 diabetes. Key Points  Aortic stiffness is associated with brain injury.  Aortic stiffness exposes small vessels to high pressure fluctuations and flow.  Aorticstiffnessisassociatedwithmicrovascular braininjury in diabetes.  This suggests a vascular contribution to early subtle microstructural deficits.