MORPHOMETRIC INDICATORS OF CEREBRAL ARTERIOLES IN DIABETIC MICROANGIOPATHY AND CEREBRAL INFARCTION IN DIABETES

Shavrin V. A., Avramenko Yu. N.

PATHOMORPHOLOGY

Scentific article

The mechanisms have adverse effects of diabetes on the vessels of the brain are not fully understood, and many questions remain related to the pathogenesis of cerebral infarction in patients with diabetes type 2. Purpose of the study. To determine the features of morphometric parameters of parenchymal microvessels (arterioles) of the cerebral cortex in diabetic microangiopathy and in ischemic cerebral infarction in diabetic microangiopathy due to diabetes mellitus type 2. The results of the study. Morphometric examination of microvessels was performed on 60 sectional cases of death of patients with type 2 diabetes, with ischemic hemispheric cerebral infarction in diabetes, and groups of conditional control without cerebral vascular pathology. The parameters were measured: a) external d1 and internal d2 diameter; b) external F1 and internal F2 form factors; c) area of the lumen; d) wall area. The formula was used: T = (d1-d2) / 2 for determining the thickness of the vascular wall. The Wogenworth index (iV) (the ratio of the wall area to the lumen area) and Kernogan index (iK) (the ratio of the wall thickness to the diameter of the vessel lumen) was calculated for estimating the functional state of the vessels. Thickening of the walls of microvessels is observed in diabetic microangiopathy. A significant increase in the thickness of the walls of arterioles is observed with ischemic cerebral infarction in diabetes – 1.8 times compared with the control and 1.3 times compared with the diabetes group. The outer diameter increases significantly and consistently from the control group (63.161 μm) to the groups with diabetes and brain infarction (68.785 μm and 77.82 μm, respectively). The inner diameter in the group with diabetes (44.695 μm) is almost unchanged compared with the control group (45.315 μm), in the group of cerebral infarctions increases to statistically significant value (48.99 μm). The Wogenworth and Kernogan indexes increase in the group with diabetes compared with the control group. An even greater increase in these indicators is observed in the group with brain infarction. Received data indicate a significant change in the function of the parenchymal microvessels of the brain in diabetic microangiopathy and ischemic infarction in patients with diabetes type 2. Conclusion. An increase in the wall thickness of the cerebral cortex arterioles is observed, their outer and inner diameters increase, the indices of the inner and outer form factors decrease, the Wogenworth index and the Kernogan index increase significantly compared with the control group in diabetic microangiopathy and in ischemic cerebral infarction of the brain with diabetes mellitus type 2

diabetes mellitus, ischemic infarction, diabetic microangiopathy, morphometry

1. Richner M, Ferreira N, Dudele A, Jensen TS, Vaegter CB, Gonçalves NP. Functional and Structural Changes of the Blood-Nerve-Barrier in Diabetic Neuropathy. Front. Neurosci. 2019;12:1038. DOI: 10.3389/fnins.2018.01038
2. Reeson P, Jeffery A, Brown CE. Illuminating the effects of stroke on the diabetic brain: insights from imaging neural and vascular networks in experimental animal models. Diabetes. 2016;65(7):1779-88. DOI: 10.2337/db16-0064
3. Barrett EJ, Liu Z, Khamaisi M, King GL, Klein R, Klein B, et al. Diabetic microvascular disease: an endocrine society scientific statement. The Journal of clinical endocrinology and metabolism. 2017;102(12):4343-410. Available from: https://doi.org/10.1210/jc.2017-01922
4. Poittevin M, Bonnin Ph, Pimpie C, Rivière L, Sebrié C, Dohan A, et al. Diabetic microangiopathy: impact of impaired cerebral vasoreactivity and delayed angiogenesis after permanent middle cerebral artery occlusion on stroke damage and cerebral repair in mice. Diabetes Mar. 2015;64(3):999-1010. DOI: 10.2337/db14-0759
5. Chen R, Ovbiagele B, Feng W. Diabetes and stroke: epidemiology, pathophysiology, pharmaceuticals and outcomes. Am J Med Sci. 2016;351(4):380-6. DOI: 10.1016/j.amjms.2016.01.011
6. Mishiro K, Imai T, Sugitani S, Kitashoji A, Suzuki Y, Takagi T, et al. Diabetes mellitus aggravates hemorrhagic transformation after ischemic stroke via mitochondrial defects leading to endothelial apoptosis. PLoS ONE. 2014;9(8):e103818. Available from: https://doi.org/10.1371/ journal.pone.0103818
7. Avtandilov GG. Osnovy kolichestvennoj patologicheskoj anatomii. Moskva: Medicinа; 2002. 240 s. [in Russian].
8. Shkrobot LV. Osoblyvosti remodeliuvannia ta morfometrychna kharakterystyka sudyn pechinky i nyrok za umov reperfuzii tonkoi kyshky pislia usunennia yii eksperymentalnoi neprokhidnosti. Tavricheskij mediko-biologicheskij vestnik. 2013;16(1):232-7. [in Ukrainian].
9. Shulhay AH, Kitsak YM. Morfometricheskaya ocenka osobennostej remodelirovaniya sosudistogo rusla terminal’nogo otdela podvzdoshnoj kishki pri mekhanicheskoj zheltukhe. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. 2013;2(42):39-42. [in Russian].
10. Petrie A, Sabin C. Medical Statistics at a Glance. 3th ed. Wiley-Blackwell. 2013. 180 p.
11. Mihaylichenko TE. Morfologicheskie izmeneniya golovnogo mozga pri diabeticheskoy entsefalopatii. Mizhnarodnyi endokrynolohichnyi zhurnal. 2017;13(7):506-14. Dostupno: https://doi.org/10.22141/2224-0721.13.7.2017.115750 [in Russian].
12. Tumanskiy VA, Avramenko YuN. Nekotoryie aspektyi morfogeneza diabeticheskoy entsefalopatii. Zaporozhskiy meditsinskiy zhurnal. 2013;4(79):39-42. Dostupno: https://doi.org/10.14739/2310-1210.2013.4.16835 [in Russian].
13. Cheng J, Chen B. The pathogenesis and clinical features of cerebrovascular disease in diabetes mellitus. Journal of Brain Science. 2015;45:45-56.
14. Tennant KA, Brown CE. Diabetes augments in vivo microvascular blood flow dynamics after stroke. Journal of Neuroscience. 2013 December 4;33(49):19194-204. Available from: https://doi.org/10.1523/jneurosci.3513-13.2013
15. McBride DW, Legrand J, Krafft PR, Flores J, Klebe D, Tang J, et al. Acute hyperglycemia is associated with immediate brain swelling and hemorrhagic transformation after middle cerebral artery occlusion in rats. Acta neurochirurgica. Supplement. 2016;121:237-41. DOI: 10.1007/978-3-319-18497-5_42.
16. Zhang Z, Yan J, Shi H. Role of hypoxia inducible factor 1 in hyperglycemia-exacerbated blood brain barrier disruption in ischemic stroke. Neurobiology of Disease. 2016. DOI: 10.1016/j.nbd.2016.07.01
17. Sweetnam D, Holmes A, Tennant KA, Zamani A, Walle M, Paul J, et al. Diabetes impairs cortical plasticity and functional recovery following ischemic stroke. Journal of Neuroscience. 2012;32(15):5132-43. Available from: https://doi.org/10.1523/jneurosci.5075-11.2012

«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 305-308 pages, index UDK 616.16:616.831.3]-091.8-02:[616.16-092-02:616.379-008.64]]-07:57.087.1

10.29254/2077-4214-2020-2-156-305-308