TY - JOUR
T1 - Cerebral white matter hyperintensity in African Americans and European Americans with type 2 diabetes
AU - Divers, Jasmin
AU - Hugenschmidt, Christina
AU - Sink, Kaycee M.
AU - Williamson, Jeffrey D.
AU - Ge, Yaorong
AU - Smith, S. Carrie
AU - Bowden, Donald W.
AU - Whitlow, Christopher T.
AU - Lyders, Eric
AU - Maldjian, Joseph A
AU - Freedman, Barry I.
N1 - Funding Information:
Supported in part by the General Clinical Research Center of the Wake Forest University School of Medicine grant MO1 RR07122 , National Institute of Diabetes and Digestive and Kidney Diseases grant RO1 DK071891 (to BIF), National Heart, Lung, and Blood Institute grant RO1 HL67348 (to DWB), National Institute of Diabetes and Digestive and Kidney Diseases grant F32 DK083214 (to CH), and National Institute of Neurological Disorders and Stroke grant RO1 NS075107 (to JD, JAM, and BIF).
PY - 2013/10
Y1 - 2013/10
N2 - Previous studies involving inner city populations detected higher cerebral white matter hyperintensity (WMH) scores in African Americans (AAs) compared with European Americans (EAs). This finding might be attributable to the higher prevalence of cardiovascular disease (CVD) risk factors and poorer access to healthcare in AAs. Despite racial differences in CVD risk factor profiles, AAs have paradoxically lower levels of subclinical CVD. We hypothesized that AAs with diabetes and good access to healthcare would have comparable or lower levels of WMH as EAs. Racial differences in the distribution of WMH were analyzed in 46 AAs and 156 EAs with type 2 diabetes enrolled in the Diabetes Heart Study (DHS)-Mind, and replicated in a sample of 113 AAs and 61 EAs patients who had clinically indicated cerebral magnetic resonance imaging. Wilcoxon 2-sample tests and linear models were used to compare the distribution of WMH in AAs and EAs and to test for association between WMH and race. The unadjusted mean WMH score from the Diabetes Heart Study-Mind was 1.9 in AAs and 2.3 in EAs (P =.3244). Among those with clinically indicated magnetic resonance imaging, the mean WMH score was 2.9 in AAs and 3.9 in EAs (P =.0503). Adjustment for age and sex produced no statistically significant differences in WMH score between AAs and EAs. These independent datasets reveal comparable WMH scores in AAs and EAs, suggesting that disparities in access to healthcare and environmental exposures likely underlie the previously reported excess burden of WMH in AAs.
AB - Previous studies involving inner city populations detected higher cerebral white matter hyperintensity (WMH) scores in African Americans (AAs) compared with European Americans (EAs). This finding might be attributable to the higher prevalence of cardiovascular disease (CVD) risk factors and poorer access to healthcare in AAs. Despite racial differences in CVD risk factor profiles, AAs have paradoxically lower levels of subclinical CVD. We hypothesized that AAs with diabetes and good access to healthcare would have comparable or lower levels of WMH as EAs. Racial differences in the distribution of WMH were analyzed in 46 AAs and 156 EAs with type 2 diabetes enrolled in the Diabetes Heart Study (DHS)-Mind, and replicated in a sample of 113 AAs and 61 EAs patients who had clinically indicated cerebral magnetic resonance imaging. Wilcoxon 2-sample tests and linear models were used to compare the distribution of WMH in AAs and EAs and to test for association between WMH and race. The unadjusted mean WMH score from the Diabetes Heart Study-Mind was 1.9 in AAs and 2.3 in EAs (P =.3244). Among those with clinically indicated magnetic resonance imaging, the mean WMH score was 2.9 in AAs and 3.9 in EAs (P =.0503). Adjustment for age and sex produced no statistically significant differences in WMH score between AAs and EAs. These independent datasets reveal comparable WMH scores in AAs and EAs, suggesting that disparities in access to healthcare and environmental exposures likely underlie the previously reported excess burden of WMH in AAs.
KW - MRI
KW - Race/ethnic differences in disease
KW - cerebrovascular disease
KW - cognitive performance
KW - healthcare disparity
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U2 - 10.1016/j.jstrokecerebrovasdis.2012.03.019
DO - 10.1016/j.jstrokecerebrovasdis.2012.03.019
M3 - Article
C2 - 22608346
AN - SCOPUS:84885968904
SN - 1052-3057
VL - 22
SP - e46-e52
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 7
ER -