Nazish Saima, Zafar Azra, Shahid Rizwana, Albakr Aishah, Alkhamis Fahd A, Aljaafari Danah, Alabdali Majed, Alsulaiman Abdullah, Al-Mulla Faisal A
Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Sultan Qaboos Univ Med J. 2018 Aug;18(3):e311-e317. doi: 10.18295/squmj.2018.18.03.008. Epub 2018 Dec 19.
This study aimed to determine the relationship between glycaemic control and carotid atherosclerotic disease among patients with acute ischaemic stroke (AIS).
This retrospective cross-sectional study took place in the Neurology Department of King Fahad Hospital of University, Khobar, Saudi Arabia, from April to October 2017. Data were collected from the medical records of 244 patients with a diagnosis of AIS confirmed by computed tomography. Doppler ultrasounds of the carotid artery were performed to determine the presence of increased carotid thickness (CIMT) and plaques.
Significantly higher mean glycated haemoglobin (HbA1c) levels were noted in cases with high CIMT values ( = 0.002), but not in cases with carotid plaques ( = 0.360). In addition, there was a significant association between diabetes mellitus (DM) and high CIMT ( = 0.045), but not with carotid plaques ( = 0.075). Finally, while dyslipidaemia and age were independently correlated with high CIMT values ( = 0.034 and <0.001, respectively) and carotid plaques ( <0.001 each), no independent relationships were noted in terms of gender and other risk factors like DM, hypertension and smoking ( >0.050 each).
High HbA1c levels were associated with high CIMT values, but not with carotid plaques. Therefore, HbA1c levels may be useful as an indirect marker of the initial stages of carotid artery atherosclerosis.
本研究旨在确定急性缺血性卒中（AIS）患者血糖控制与颈动脉粥样硬化疾病之间的关系。
这项回顾性横断面研究于2017年4月至10月在沙特阿拉伯胡拜尔法赫德国王大学医院神经科进行。从244例经计算机断层扫描确诊为AIS的患者病历中收集数据。进行颈动脉多普勒超声检查以确定颈动脉内膜中层厚度（CIMT）增加和斑块的存在情况。
CIMT值高的病例糖化血红蛋白（HbA1c）平均水平显著更高（P = 0.002），但颈动脉有斑块的病例中未出现这种情况（P = 0.360）。此外，糖尿病（DM）与高CIMT之间存在显著关联（P = 0.045），但与颈动脉斑块无关（P = 0.075）。最后，虽然血脂异常和年龄分别与高CIMT值（P = 0.034和P<0.001）以及颈动脉斑块（均为P<0.001）独立相关，但在性别以及DM、高血压和吸烟等其他危险因素方面未发现独立关系（均为P>0.050）。
高HbA1c水平与高CIMT值相关，但与颈动脉斑块无关。因此，HbA1c水平可能作为颈动脉粥样硬化初始阶段的间接标志物。
