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001-es BibID:BIBFORM042400
Első szerző:Fülesdi Béla (aneszteziológus)
Cím:No relationship between cerebral blood flow velocity and cerebrovascular reserve capacity and contemporaneously measured glucose and insulin concentrations in diabetes mellitus / Fülesdi, B., Limburg, M., Bereczki, D., Molnár, C., Michels, R. P. J., Leányvári, Z., Csiba, L.
Dátum:1999
ISSN:0940-5429
Megjegyzések:Blood glucose and insulin concentrations have been reported to influence cerebral hemodynamics. We studied the relationship between actual blood glucose and insulin concentrations and resting cerebral blood flow velocity in the middle cerebral artery and cerebrovascular reserve capacity after acetazolamide stimulation. Thirty-six insulin-dependent diabetic patients in a state of good glycemic control were studied. Blood samples were taken for determination of glucose and insulin concentrations. Subsequently we measured resting cerebral blood flow velocities in supine position using transcranial Doppler, administered 1 g acetazolamide intravenously, and repeated the measurements after 5, 10, 15 and 20 minutes. Cerebrovascular reserve was calculated as the maximal percent increase after acetazolamide stimulation. Multiple regression was used for statistical analysis. Blood glucose levels were not correlated with resting blood flow velocity (R = 0.21, p = 0.22) nor cerebrovascular reserve capacity (R = 0.17, p = 0.32). Similarly, no correlation was found between insulin concentrations, resting cerebral blood flow velocity (R = 0.24, p = 0.22) and cerebrovascular reserve (R = 0.26, p = 0.24). Studying patients with long-term (> 10 years) and short-term (</= 10 years) disease duration yielded the same lack of correlation. We conclude that there is no significant correlation between contemporaneously measured glucose and insulin concentrations and either cerebral blood flow velocity or cerebrovascular reserve capacity in the middle cerebral artery in type 1 diabetic patients with good control.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Acta Diabetologica. - 36 : 4 (1999), p. 191-195. -
További szerzők:Limburg, Martien Bereczki Dániel (1960-) (neurológus) Molnár Csilla (1962-) (aneszteziológus) Michels, R. P. J. Leányvári Zsolt (1968-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter)
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001-es BibID:BIBFORM042395
Első szerző:Fülesdi Béla (aneszteziológus)
Cím:Impairment of cerebrovascular reactivity in long-term type 1 diabetes / Fulesdi, B., Limburg, M., Bereczki, D., Michels, R. P., Neuwirth, G., Legemate, D., Valikovics, A., Csiba, L.
Dátum:1997
ISSN:0012-1797
Megjegyzések:The early preclinical detection of cerebrovascular complications in individuals with diabetes is one of the goals of care described in the St. Vincent Declaration. In accordance with this goal, the aim of the present work was to investigate whether altered cerebral microvascular function in patients suffering from type 1 diabetes can be detected with a transcranial Doppler probe after the administration of acetazolamide. A total of 72 type 1 diabetic patients and 40 healthy control subjects entered the study. Patients were divided into two groups: those with long-term diabetes (disease duration of >10 years, n = 37) and those with short-term diabetes (disease duration of < or =10 years, n = 35). Mean blood-flow velocity in the middle cerebral artery (MCAV) was measured at rest and at 5, 10, 15, and 20 min after intravenous administration of 1 g acetazolamide with a transcranial Doppler probe and expressed as the percentage change from the pretest measurement. The percentage increase in MCAV (cerebrovascular reactivity) was calculated at each time point and compared between the groups. Cerebrovascular reserve capacity (CRC), expressed as the maximal percentage increase of the MCAV, was compared between the groups. Additionally, a reproducibility study of CRC was performed in 10 patients, using intraclass correlations. Cerebrovascular reactivity in the long-term diabetes group was lower (means +/- SD: 5 min, 23.4 +/- 15.4%; 10 min, 28.8 +/- 17.0%; 15 min, 30.0 +/- 15.6%; 20 min, 24.2 +/- 17.8%) than that of the control subjects (5 min, 43.5 +/- 23.9%; 10 min, 55.3 +/- 24.0%; 15 min, 56.7 +/- 23.8%; 20 min, 54.8 +/- 25.9%) and the short-term diabetic patients (5 min, 43.6 +/- 25.9%; 10 min, 52.2 +/- 27.7%; 15 min, 55.3 +/- 32.2%; 20 min, 45.8 +/- 35.8%). CRC was lower in the long-term diabetes group than in the control group or the short-term diabetes group. Impairment of cerebrovascular reactivity was associated with retino- and nephropathy and increased levels of fibrinogen. In contrast, CRC was independent from actual glucose, insulin, glycosylated hemoglobin, von Willebrand factor antigen, and alpha-2 macroglobulin levels. Transcranial Doppler measurements of the changes in MCAV after stimulation with acetazolamide can detect altered cerebral microvascular function in patients with diabetes. Cerebrovascular reactivity and reserve capacity are reduced in patients with long-term diabetes. Further prospective studies should delineate the clinical significance of our results.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Diabetes. - 46 : 11 (1997), p. 1840-1845. -
További szerzők:Limburg, Martien Bereczki Dániel (1960-) (neurológus) Michels, R. P. J. Neuwirth Gyula Legemate, D. Valikovics Attila Csiba László (1952-) (neurológus, pszichiáter)
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Intézményi repozitóriumban (DEA) tárolt változat
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