{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T01:48:20Z","timestamp":1770688100027,"version":"3.49.0"},"reference-count":70,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Type 1 diabetes (T1D) increases the risk for cerebral microangiopathy. However, the association between gender and cerebral microcirculatory dysfunction in T1D remains undetermined. Therefore, we have conducted a comparative analysis of cerebral endothelial-mediated microcirculatory parameters between middle-aged Caucasian females and males with type 1 diabetes. The present study examined the nitric oxide-induced vasomotor reactivity of middle cerebral arteries (MCA using transcranial Doppler and L\u2013arginine infusion (L\u2013arg VMR)). The study compared L\u2013arg VMR between 23 males and 26 females with type 1 diabetes without a history of overt cerebrovascular disease. Mean L\u2013arg VMR and baseline MCA flow velocity (V rest) were higher in females than in males (20.1 \u00b1 5.4 vs. 14.6 \u00b1 7.1% p &lt; 0.01 and 73, 54\u2013106 vs. 60.7\u201377 cm\/s p &lt; 0.01, respectively). Males were older than females (39.7 [range: 31.3\u201355.7] vs. 36.5 [range: 25.0\u201345.5] years, p = 0.02) and were characterized by later T1D onset and higher insulin\/24 h, triglyceride levels and body mass index (BMI). Higher L\u2013arg VMR in females persisted when co-variated with patients\u2019 age, age of onset, BMI, triglyceride level and V rest. Cerebral vasomotor reactivity to L\u2013arginine showed greater efficacy in middle-aged females than in males with T1D, independent of age and disease course. The protective effect of the female gender on cerebral endothelium function has been demonstrated in type 1 diabetes.<\/jats:p>","DOI":"10.3390\/ijms27041662","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T08:15:54Z","timestamp":1770624954000},"page":"1662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gender-Related Differences in Cerebrovascular Reactivity to L\u2013Arginine in Middle-Aged Type 1 Diabetes Patients"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7704-2434","authenticated-orcid":false,"given":"Grzegorz M.","family":"Kozera","sequence":"first","affiliation":[{"name":"Medical Simulation Centre, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9175-3862","authenticated-orcid":false,"given":"Jolanta","family":"Neubauer-Geryk","sequence":"additional","affiliation":[{"name":"Medical Simulation Centre, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogumi\u0142","family":"Wolnik","sequence":"additional","affiliation":[{"name":"Department of Hypertension and Diabetology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-7691","authenticated-orcid":false,"given":"Sebastian","family":"Szczyrba","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leszek","family":"Bieniaszewski","sequence":"additional","affiliation":[{"name":"Medical Simulation Centre, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.2337\/diab.46.11.1840","article-title":"Impairment of Cerebrovascular Reactivity in Long-Term Type 1 Diabetes","volume":"46","author":"Limburg","year":"1997","journal-title":"Diabetes"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1475-097X.1986.tb00788.x","article-title":"Impaired Autoregulation of Cerebral Blood Flow in Long-term Type I (Insulin-dependent) Diabetic Patients with Nephropathy and Retinopathy","volume":"6","author":"Kastrup","year":"1986","journal-title":"Clin. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1002\/jcu.20617","article-title":"Carotid Intima-media Thickness and Cerebrovascular Reactivity in Long-term Type 1 Diabetes Mellitus","volume":"37","author":"Katona","year":"2009","journal-title":"J. Clin. Ultrasound"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"878","DOI":"10.2337\/dc08-1805","article-title":"Cerebrovascular Reactivity, Intima-Media Thickness, and Nephropathy Presence in Patients with Type 1 Diabetes","volume":"32","author":"Kozera","year":"2009","journal-title":"Diabetes Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5114\/ada.2018.81185","article-title":"Cerebral and Skin Microcirculatory Dysfunction in Type 1 Diabetes","volume":"36","author":"Kozera","year":"2019","journal-title":"Adv. Dermatol. Allergol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"858","DOI":"10.2337\/dc14-1792","article-title":"Regional Cerebral Hemodynamic Response to Incremental Exercise Is Blunted in Poorly Controlled Patients with Uncomplicated Type 1 Diabetes","volume":"38","author":"Tagougui","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00592-018-1200-5","article-title":"Measuring Visual Cortical Oxygenation in Diabetes Using Functional Near-Infrared Spectroscopy","volume":"55","author":"Aitchison","year":"2018","journal-title":"Acta Diabetol."},{"key":"ref_8","first-page":"776","article-title":"Progression of Cerebral Small Vessel Disease Among Neurologically Asymptomatic Middle-Aged Individuals with Type 1 Diabetes","volume":"48","author":"Tarkkonen","year":"2025","journal-title":"Diabetes Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/jcu.1870230903","article-title":"Transcranial Doppler Ultrasound Assessment of Intracranial Hemodynamics in Children with Diabetic Ketoacidosis","volume":"23","author":"Hoffman","year":"1995","journal-title":"J. Clin. Ultrasound"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.2337\/dc06-2363","article-title":"Prospective Study of Type 1 and Type 2 Diabetes and Risk of Stroke Subtypes","volume":"30","author":"Janghorbani","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1212\/01.WNL.0000123252.55688.05","article-title":"Stroke Patterns, Etiology, and Prognosis in Patients with Diabetes Mellitus","volume":"62","author":"Karapanayiotides","year":"2004","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s005920170006","article-title":"Lack of Gender Difference in Acetazolamide-Induced Cerebral Vasomotor Reactivity in Patients Suffering from Type-1 Diabetes Mellitus","volume":"38","author":"Limburg","year":"2001","journal-title":"Acta Diabetol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/aos.13654","article-title":"Diabetic Retinopathy in Type 1 Diabetes Patients in Western Norway","volume":"96","author":"Jansson","year":"2018","journal-title":"Acta Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"420","DOI":"10.2337\/dc17-0906","article-title":"Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for up to 42 Years","volume":"41","author":"Gagnum","year":"2018","journal-title":"Diabetes Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s13340-017-0336-9","article-title":"The Incidences of and Risk Factors for Severe Retinopathy Requiring Photocoagulation and Albuminuria in Japanese Patients with Childhood-Onset Type 1 Diabetes","volume":"9","author":"Takaike","year":"2018","journal-title":"Diabetol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s12020-019-02047-z","article-title":"Risk Factors for Prevalent Diabetic Retinopathy and Proliferative Diabetic Retinopathy in Type 1 Diabetes","volume":"66","author":"Laiginhas","year":"2019","journal-title":"Endocrine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.2337\/dc18-0679","article-title":"Development of Microvascular Complications and Effect of Concurrent Risk Factors in Type 1 Diabetes: A Multistate Model from an Observational Clinical Cohort Study","volume":"41","author":"Bjerg","year":"2018","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/aos.13815","article-title":"Risk Factors for Development and Progression of Diabetic Retinopathy in Dutch Patients with Type 1 Diabetes Mellitus","volume":"96","author":"Schreur","year":"2018","journal-title":"Acta Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ang, S.P., Chia, J.E., Iglesias, J., Krittanawong, C., Tangsrivimol, J.A., Khalid, U., and Mukherjee, D. (2025). Sex-Specific Trends and Differences in Clinical Outcomes Among Young Patients with Ischemic Stroke. Angiology, Online ahead of print.","DOI":"10.1177\/00033197251392666"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.06.020","article-title":"Temporal Trends of Sex Differences in Transient Ischemic Attack Incidence Within a Population","volume":"28","author":"Madsen","year":"2019","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1161\/STROKEAHA.120.028910","article-title":"Temporal Trends in Stroke Incidence Over Time by Sex and Age in the GCNKSS","volume":"51","author":"Madsen","year":"2020","journal-title":"Stroke"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1007\/s00394-023-03123-x","article-title":"Dietary Magnesium Intake Is Related to Larger Brain Volumes and Lower White Matter Lesions with Notable Sex Differences","volume":"62","author":"Alateeq","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_23","first-page":"252","article-title":"Transcranial Doppler Study of the Cerebral Hemodynamic Changes During Breath-Holding and Hyperventilation Tests","volume":"12","author":"Settakis","year":"2002","journal-title":"J. Neuroimaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1161\/01.STR.23.5.668","article-title":"Estimation of Cerebrovascular Reactivity Using Transcranial Doppler, Including the Use of Breath-Holding as the Vasodilatory Stimulus","volume":"23","author":"Markus","year":"1992","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1161\/01.STR.31.4.924","article-title":"Reduced Vasomotor Reactivity in Cerebral Microangiopathy: A study with near-infrared spectroscopy and transcranial Doppler sonography","volume":"31","author":"Terborg","year":"2000","journal-title":"Stroke"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1002\/mrm.70091","article-title":"Transcranial Doppler Ultrasound Validation of BOLD-fMRI Cerebral Blood Flow Relationship","volume":"95","author":"Hayes","year":"2026","journal-title":"Magn. Reson. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s13089-025-00445-1","article-title":"Cerebrovascular Reactivity Metrics as Predictors of Cognitive Performance in Healthy Ageing: Insights from Transcranial Colour-Coded Ultrasound","volume":"17","author":"Ackah","year":"2025","journal-title":"Ultrasound J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/j.1552-6569.2003.tb00166.x","article-title":"Cerebrovascular Reactivity in Hypertensive and Healthy Adolescents: TCD with Vasodilatory Challenge","volume":"13","author":"Settakis","year":"2003","journal-title":"J. Neuroimaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1161\/01.STR.0000131748.12553.ed","article-title":"Effect of Perindopril on Cerebral Vasomotor Reactivity in Patients with Lacunar Infarction","volume":"35","author":"Walters","year":"2004","journal-title":"Stroke"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"P\u00e1l, H., Magyar-Stang, R., Cs\u00e1nyi, B., Ga\u00e1l, A., Mih\u00e1ly, Z., Czinege, Z., S\u00f3tonyi, P., Horv\u00e1th, T., Dobi, B., and Bereczki, D. (2025). Complex Characterization of Cerebral Vasoreactivity in Internal Carotid Artery Stenotic Patients with Transcranial Doppler Sonography. Life, 15.","DOI":"10.3390\/life15111692"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Piec, K., Marek-J\u00f3zefowicz, L., Nadolska, K., Lemanowicz, A., Serafin, Z., and Kozera, G. (2024). Early Cerebral Microvasculature Impairment and Increased Body Mass Index in Patients with Psoriasis. Biomedicines, 12.","DOI":"10.3390\/biomedicines12081627"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1161\/01.STR.30.11.2296","article-title":"Impaired Cerebrovascular Reactivity as a Risk Marker for First-Ever Lacunar Infarction","volume":"30","author":"Molina","year":"1999","journal-title":"Stroke"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000097018","article-title":"Hyperventilation-Induced Cerebrovascular Reactivity among Hypertensive and Healthy Adolescents","volume":"29","author":"Settakis","year":"2006","journal-title":"Kidney Blood Press Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1038\/ajh.2010.152","article-title":"Cerebral Vasomotor Reactivity and Extent of White Matter Lesions in Middle-Aged Men with Arterial Hypertension: A Pilot Study","volume":"23","author":"Kozera","year":"2010","journal-title":"Am. J. Hypertens."},{"key":"ref_35","first-page":"601515","article-title":"Cerebral Endothelial Function Determined by Cerebrovascular Reactivity to L\u2013arginine","volume":"2014","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_36","first-page":"256","article-title":"Testing of Cerebral Endothelium Function with L\u2013arginine after Stroke","volume":"21","author":"Zvan","year":"2002","journal-title":"Int. Angiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2540","DOI":"10.1161\/01.STR.0000239659.99112.fb","article-title":"Influence of Atorvastatin Treatment on l-Arginine Cerebrovascular Reactivity and Flow-Mediated Dilatation in Patients with Lacunar Infarctions","volume":"37","author":"Sabovic","year":"2006","journal-title":"Stroke"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1159\/000052786","article-title":"Diminished Reserve for Cerebral Vasomotor Response to L-Arginine in the Elderly: Evaluation by Transcranial Doppler Sonography","volume":"47","author":"Okamoto","year":"2001","journal-title":"Gerontology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1159\/000090530","article-title":"Cerebrovascular Reactivity to L-Arginine in Patients with Lacunar Infarctions","volume":"21","author":"Zaletel","year":"2006","journal-title":"Cerebrovasc. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1161\/HYPERTENSIONAHA.116.07698","article-title":"Evidence for Shear Stress\u2013Mediated Dilation of the Internal Carotid Artery in Humans","volume":"68","author":"Carter","year":"2016","journal-title":"Hypertension"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1161\/01.STR.28.12.2353","article-title":"Sex Dependency of Cerebrovascular CO2 Reactivity in Normal Subjects","volume":"28","author":"Kastrup","year":"1997","journal-title":"Stroke"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/jon2000103151","article-title":"Gender-Related Differences in Acetazolamide-Induced Cerebral Vasodilatory Response: A Transcranial Doppler Study","volume":"10","author":"Valikovics","year":"2000","journal-title":"J. Neuroimaging"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1161\/01.STR.27.1.56","article-title":"Sex-Related Differences in Acetazolamide-Induced Cerebral Vasomotor Reactivity","volume":"27","author":"Karnik","year":"1996","journal-title":"Stroke"},{"key":"ref_44","first-page":"1","article-title":"Sex Differences in the Cerebral Hemodynamic Response to Hypercapnia in Young Adults","volume":"34","author":"Miller","year":"2020","journal-title":"FASEB J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/0002-9378(95)91492-7","article-title":"Hormonal Status Affects the Reactivity of the Cerebral Vasculature","volume":"172","author":"Belfort","year":"1995","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1046\/j.1469-0705.1999.14010052.x","article-title":"The Effect of the Menstrual Cycle on Human Cerebral Blood Flow: Studies Using Doppler Ultrasound","volume":"14","author":"Brackley","year":"1999","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jns.2004.03.028","article-title":"Influence of 17-Beta-Estradiol on Cerebrovascular Impedance during Menstrual Cycle in Women","volume":"221","author":"Krejza","year":"2004","journal-title":"J. Neurol. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"H920","DOI":"10.1152\/ajpheart.00474.2018","article-title":"Sex Differences in Cerebral Autoregulation Are Unaffected by Menstrual Cycle Phase in Young, Healthy Women","volume":"316","author":"Favre","year":"2019","journal-title":"Am. J. Physiol.-Heart Circ. Physiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e15287","DOI":"10.14814\/phy2.15287","article-title":"Cerebral Autoregulation across the Menstrual Cycle in Eumenorrheic Women","volume":"10","author":"Korad","year":"2022","journal-title":"Physiol. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"103054","DOI":"10.1016\/j.autneu.2022.103054","article-title":"Oral Contraceptive Use and Menstrual Cycle Influence Acute Cerebrovascular Response to Standing","volume":"244","author":"Barranca","year":"2023","journal-title":"Auton. Neurosci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1113\/EP092245","article-title":"Challenging Dynamic Cerebral Autoregulation across the Physiological CO2 Spectrum: Influence of Biological Sex and Cardiac Cycle","volume":"110","author":"Johnson","year":"2025","journal-title":"Exp. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1152\/japplphysiol.01270.2011","article-title":"Cyclooxygenase Inhibition Abolishes Age-Related Differences in Cerebral Vasodilator Responses to Hypercapnia","volume":"112","author":"Barnes","year":"2012","journal-title":"J. Appl. Physiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jdiacomp.2014.10.002","article-title":"Diabetic Symmetric Polyneuropathy Is Associated with Increased Aortal Stiffening but Not Cerebral Angiopathy in Type 1 Diabetes","volume":"29","author":"Szczyrba","year":"2015","journal-title":"J. Diabetes Complicat."},{"key":"ref_54","first-page":"1","article-title":"Czynno\u015bciowa Ocena Mikrokr\u0105\u017cenia M\u00f3zgowego u Pacjent\u00f3w z Cukrzyc\u0105 Typu 1 Za Pomoc\u0105 Przezczaszkowej Ultrasonografii Dopplerowskiej Oraz Testu Infuzji L-Argin. Rozprawa Habilitacyjna. Functional Assessment of Cerebral Microvasculature in Patients with Type 1 Diabetes with Use of Transcranial Doppler and L\u2013arginine Infusion","volume":"LXI","author":"Kozera","year":"2011","journal-title":"Ann. Acad. Medicae Gedanensis"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0022-510X(99)00027-1","article-title":"Vasomotor Response to CO2 and L\u2013arginine in Patients with Severe Internal Carotid Artery Stenosis; Pre- and Post-Surgical Evaluation with Transcranial Doppler","volume":"163","author":"Micieli","year":"1999","journal-title":"J. Neurol. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S0022-510X(97)05380-X","article-title":"Opposite Effects of L\u2013arginine and Nitroglycerin on Cerebral Blood Velocity: Nitric Oxide Precursors and Cerebral Blood Velocity","volume":"150","author":"Micieli","year":"1997","journal-title":"J. Neurol. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1161\/01.CIR.0000057973.99140.5A","article-title":"Role of Nitric Oxide in the Regulation of Cerebral Blood Flow in Humans","volume":"107","author":"Lavi","year":"2003","journal-title":"Circulation"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1056\/NEJM199312303292706","article-title":"The L\u2013arginine-Nitric Oxide Pathway","volume":"329","author":"Epstein","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1161\/01.STR.16.3.477","article-title":"Upper Limit of Cerebral Autoregulation during Development of Hypertension in Spontaneously Hypertensive Rats\u2013Effect of Sympathetic Denervation","volume":"16","author":"Sadoshima","year":"1985","journal-title":"Stroke"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1152\/japplphysiol.00471.2004","article-title":"Cerebral Pressure-Flow Relations in Hypertensive Elderly Humans: Transfer Gain in Different Frequency Domains","volume":"98","author":"Serrador","year":"2005","journal-title":"J. Appl. Physiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1038\/ajh.2008.153","article-title":"Statin Treatment Improves Cerebral More Than Systemic Endothelial Dysfunction in Patients with Arterial Hypertension","volume":"21","author":"Sebestjen","year":"2008","journal-title":"Am. J. Hypertens."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1159\/000322562","article-title":"Differences between Cerebrovascular Reactivity to l-Arginine in the Anterior and Posterior Cerebral Circulation","volume":"31","author":"Perko","year":"2011","journal-title":"Cerebrovasc. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1600-0404.2010.01468.x","article-title":"Cerebrovascular Reactivity to L\u2013arginine in the Anterior and Posterior Cerebral Circulation in Migraine Patients","volume":"124","author":"Perko","year":"2011","journal-title":"Acta Neurol. Scand."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1167\/iovs.14-15147","article-title":"Sex Differences in Retinal Microvasculature Through Puberty In Type 1 Diabetes: Are Girls at Greater Risk of Diabetic Microvascular Complications?","volume":"56","author":"Craig","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Neubauer-Geryk, J., My\u015bliwiec, M., and Bieniaszewski, L. (2024). Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes. Biomedicines, 12.","DOI":"10.3390\/biomedicines12071413"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1161\/STROKEAHA.125.051026","article-title":"Sex Differences in the Neurovascular Health of Aging Adults","volume":"56","author":"Sussman","year":"2025","journal-title":"Stroke"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2010). Standards of Medical Care in Diabetes\u20142010. Diabetes Care, 33, S11\u2013S61. Erratum in Diabetes Care 2010, 33, 692.","DOI":"10.2337\/dc10-S011"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1046\/j.1523-1755.2001.00789.x","article-title":"Microalbuminuria in Type 1 Diabetes: Rates, Risk Factors and Glycemic Threshold","volume":"60","author":"Chaturvedi","year":"2001","journal-title":"Kidney Int."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"(1992). Screening Guidelines for Diabetic Retinopathy. American College of Physicians, American Diabetes Association, and American Academy of Ophthalmology. Ann. Intern. Med., 116, 683\u2013685.","DOI":"10.7326\/0003-4819-116-8-683"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/mus.880110106","article-title":"Detection, Characterization, and Staging of Polyneuropathy: Assessed in Diabetics","volume":"11","author":"Dyck","year":"1988","journal-title":"Muscle Nerve"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/4\/1662\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T08:23:59Z","timestamp":1770625439000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/4\/1662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":70,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["ijms27041662"],"URL":"https:\/\/doi.org\/10.3390\/ijms27041662","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}