Trans-cranial duplex and visfatin as markers for cerebrovascular complications in type 2 diabetes mellitus

Samaa Ayman; Sahar Nassef; Nagwa Ramadan; Dina Sabry; Kareem Mohsen Moussa; Ahmed Fayed

Samaa Ayman Vascular Medicine Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Egypt.
Sahar Nassef Vascular Medicine Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Egypt.
Nagwa Ramadan Endocrinology Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Egypt.
Dina Sabry Medical Biochemistry and Molecular Biology Department, Kasr Alainy School of Medicine, Cairo University, Egypt.
Kareem Mohsen Moussa Radiodiagnosis Department, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Egypt.
Ahmed Fayed Nephrology Unit, Internal Medicine Department, Kasr Alainy School of Medicine, Cairo University, Egypt. https://orcid.org/0000-0002-6041-4016

Keywords: Type 2 diabetes mellitus; Transcranial Doppler; Visfatin; Microvascular complications; Macro-vascular complications.

Abstract

Background and aims: Transcranial Doppler (TCD) is a modern and sophisticated diagnostic procedure that enables recording the changes in cerebral perfusion in various states. We aimed to look into the role of TCD in studying the cerebral changes that occur in type 2 diabetic patients, as well as their relationship to visfatin and macro-and microvascular complications. Material and method: Twenty diabetic patients with no vascular complications were placed in group1, twenty diabetic patients with macrovascular complications were placed in group2, and forty diabetic patients with microvascular complications were placed in group 3. Serum visfatin level and TCD were performed on all patients. Results: The pulsatile index of the right and left middle cerebral arteries (PI RT & LT MCA) have high sensitivity (69.2% and 64.1%, respectively) and specificity (75% and 95%) in predicting microvascular complications, with cut-off values of (1.005 and 1.035). A positive significant correlation between serum visfatin level and PI RT, and LT MCA with (p <0.001, =0.035 respectively) among diabetics with no complications group, (p<0.001) in both macro and micro-vascular complications group. Conclusion: TCD is a non-invasive technique for determining brain circulation and predicting complications and prognosis in high-risk diabetics.