空腹血糖和糖化血红蛋白水平作为颅内动脉粥样硬化狭窄存在的危险因素。
Fasting glucose and HbA levels as risk factors for the presence of intracranial atherosclerotic stenosis.
作者信息
Wang Yan-Li, Leng Xin-Yi, Dong Yi, Hou Xiao-He, Tong Lin, Ma Ya-Hui, Xu Wei, Cui Mei, Dong Qiang, Tan Lan, Yu Jin-Tai
机构信息
Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
出版信息
Ann Transl Med. 2019 Dec;7(24):804. doi: 10.21037/atm.2019.12.56.
BACKGROUND
Intracranial atherosclerotic stenosis (ICAS) is the most common cause of stroke, but the relationship of ICAS with fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA) is unclear. This study aimed to investigate the effects of increased FBG and HbA concentration on ICAS.
METHODS
A total of 4,012 patients aged over 40 years who underwent cerebral magnetic resonance angiography (MRA) were enrolled in this study, including 1,434 non-stroke controls and 2,578 patients with ischemic stroke. Participants were classified into four groups according to stroke and ICAS status. ICAS was defined as the presence of ≥50% stenosis in any intracranial artery. Multivariate regression analysis was used to evaluate the associations of FBG and HbA with ICAS.
RESULTS
Levels of fasting glucose and HbA in patients with ICAS were significantly higher than those in patients without ICAS among both stroke and non-stroke groups. Multivariate regression analysis showed that elevated levels of fasting glucose (OR 1.14, 95% CI, 1.11-1.18, P<0.001) and HbA (OR 1.22, 95% CI, 1.16-1.28, P<0.001) were independent risk factors for ICAS. In addition, patients with the DM (FBG ≥7.0 mmol/L) were at the high risk of ICAS in both non-stroke (OR 2.90, 95% CI, 2.11-3.99, P<0.001) and stroke (OR 1.99, 95% CI, 1.67-2.39, P<0.001) groups. Besides, subjects with the high risk of ICAS were found in the fourth HbA quartile in both non-stroke (OR 3.50, 95% CI, 2.23-5.61, P<0.001) and stroke (OR 1.98, 95% CI, 1.50-2.63, P<0.001) groups.
CONCLUSIONS
The results suggest that elevated fasting glucose and HbA levels are associated with high risk for ICAS.
背景
颅内动脉粥样硬化性狭窄（ICAS）是中风最常见的病因，但ICAS与空腹血糖（FBG）和糖化血红蛋白A1c（HbA）之间的关系尚不清楚。本研究旨在探讨FBG和HbA浓度升高对ICAS的影响。
方法
本研究共纳入4012例年龄超过40岁且接受脑磁共振血管造影（MRA）检查的患者，包括1434例非中风对照组和2578例缺血性中风患者。参与者根据中风和ICAS状态分为四组。ICAS定义为任何颅内动脉存在≥50%的狭窄。采用多因素回归分析评估FBG和HbA与ICAS的相关性。
结果
在中风组和非中风组中，ICAS患者的空腹血糖和HbA水平均显著高于无ICAS患者。多因素回归分析显示，空腹血糖水平升高（比值比[OR]1.14，95%置信区间[CI]，1.11 - 1.18，P<0.001）和HbA水平升高（OR 1.22，95% CI，1.16 - 1.28，P<0.001）是ICAS的独立危险因素。此外，糖尿病患者（FBG≥7.0 mmol/L）在非中风组（OR 2.90，95% CI，2.11 - 3.99，P<0.001）和中风组（OR 1.99，95% CI，1.67 - 2.39，P<0.001）中发生ICAS的风险均较高。此外，在非中风组（OR 3.50，95% CI，2.23 - 5.61，P<0.001）和中风组（OR 1.98，95% CI，1.50 - 2.63，P<0.001）中，HbA处于第四个四分位数的受试者发生ICAS的风险较高。
结论
结果表明，空腹血糖和HbA水平升高与ICAS的高风险相关。
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