Wang Jing, Wu Jianwei, Zhang Shufeng, Zhang Liqun, Wang Chunxue, Gao Xiang, Zhou Yong, Wang Anxin, Wu Shouling, Zhao Xingquan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, The General Hospital of Chinese People's Armed Police Forces, Beijing, China.
Atherosclerosis. 2014 Dec;237(2):661-5. doi: 10.1016/j.atherosclerosis.2014.10.083. Epub 2014 Oct 23.
Cerebral artery stenosis is known as an important cause of stroke, and elevated fasting glucose level is also considered as a risk factor for stroke. Our aim was to exam whether elevated fasting glucose is associated with cerebral artery stenosis, especially asymptomatic cerebral artery stenosis.
The current study included 5309 participants who were age of 40 years or older, and free of stroke, transient ischemic attack, and coronary artery disease. Cerebral artery stenosis was assessed by Doppler ultrasound. Participants were classified into four subtypes: no cerebral artery stenosis (NCS), intracranial artery stenosis (ICAS), extracranial carotid artery stenosis (ECCS) and combined intracranial artery and extracranial carotid artery stenosis (IECS). Fasting blood glucose concentrations were grouped into: normal fasting glucose (<5.60 mmol/l), impaired fasting glucose 1 (IFG1) (5.60-6.09 mmol/l), IFG2 (6.10-6.99 mmol/l) and diabetes (≥ 7.00 mmol/l). A multinomial logistic regression was used to examine the association between fasting glucose and cerebral artery stenosis, after adjusting for potential confounders.
Fasting glucose level was significantly higher in ICAS and IECS groups than the other two groups. In the multinomial logistic regression analysis, IFG2 was the risk factor for ICAS (odds ratio (OR) 1.53, 95% confidential interval (CI), 1.12-2.10), and diabetes was a strong predictor for both ICAS (OR 1.75, 95% CI, 1.38-2.22) and IECS (OR 2.14, 95% CI 1.31-3.49). However, fasting glucose level was not significantly associated with ECCS.
Our results showed that elevated fasting glucose levels are associated with asymptomatic cerebral artery stenosis, especially ICAS and IECS.
脑动脉狭窄是已知的中风重要病因，空腹血糖水平升高也被视为中风的一个危险因素。我们的目的是检验空腹血糖升高是否与脑动脉狭窄相关，尤其是无症状脑动脉狭窄。
本研究纳入了5309名年龄在40岁及以上、无中风、短暂性脑缺血发作和冠状动脉疾病的参与者。通过多普勒超声评估脑动脉狭窄情况。参与者被分为四种亚型：无脑动脉狭窄（NCS）、颅内动脉狭窄（ICAS）、颅外颈动脉狭窄（ECCS）以及颅内动脉和颅外颈动脉联合狭窄（IECS）。空腹血糖浓度被分为：空腹血糖正常（<5.60 mmol/l）、空腹血糖受损1（IFG1）（5.60 - 6.09 mmol/l）、IFG2（6.10 - 6.99 mmol/l）和糖尿病（≥7.00 mmol/l）。在调整潜在混杂因素后，采用多项逻辑回归分析来检验空腹血糖与脑动脉狭窄之间的关联。
ICAS组和IECS组的空腹血糖水平显著高于其他两组。在多项逻辑回归分析中，IFG2是ICAS的危险因素（比值比（OR）1.53，95%置信区间（CI），1.12 - 2.10），糖尿病是ICAS（OR 1.75，95% CI，1.38 - 2.22）和IECS（OR 2.14，95% CI 1.31 - 3.49）的强预测因素。然而，空腹血糖水平与ECCS无显著关联。
我们的结果表明，空腹血糖水平升高与无症状脑动脉狭窄相关，尤其是ICAS和IECS。
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