Department of Radiology, National Center of Gerontology, Beijing Hospital, Beijing, China.
Department of Neurology, National Center of Gerontology, Beijing Hospital, Beijing, China.
J Diabetes Investig. 2020 Sep;11(5):1278-1284. doi: 10.1111/jdi.13239. Epub 2020 Mar 25.
AIMS/INTRODUCTION: Type 2 diabetes mellitus is a specific risk factor for intracranial atherosclerosis. The purpose of this study was to investigate the relationship between type 2 diabetes mellitus, especially uncontrolled glycemia, and intracranial plaque characteristics using high-resolution magnetic resonance imaging.
A total of 263 patients (182 men; mean age 62.6 ± 11.5 years) with intracranial atherosclerotic plaques detected on high-resolution magnetic resonance imaging from December 2017 to March 2019 were included in this study. Patients were divided into different groups: (i) patients with and without type 2 diabetes mellitus; (ii) diabetes patients with uncontrolled glycemia (glycated hemoglobin level ≥7.0%) and controlled glycemia; and (iii), diabetes patients with diabetes duration of <5, 5-10 and >10 years. Comparisons of plaque features between groups were made, respectively.
Type 2 diabetes mellitus was diagnosed in 118 patients (44.9%). Diabetes patients had a significantly greater prevalence of enhanced plaque, greater maximum plaque length, maximum wall thickness and more severe luminal stenosis than non-diabetes patients. Compared with diabetes patients with controlled glycemia, those with uncontrolled glycemia had a significantly greater prevalence of enhanced plaque and greater maximum plaque length (all P < 0.05). There were no significant differences in plaque features among patients with different durations of type 2 diabetes mellitus. Uncontrolled glycemia was an independent factor for plaque enhancement after adjustment for potential confounding factors (odds ratio 5.690; 95% confidence interval 1.748-18.526; P = 0.004).
Type 2 diabetes mellitus is closely related to intracranial plaque enhancement and burden. Recently uncontrolled glycemia might play an important role in the development of enhanced plaque.
目的/引言：2 型糖尿病是颅内动脉粥样硬化的一个特定危险因素。本研究旨在使用高分辨率磁共振成像（MRI）研究 2 型糖尿病（尤其是血糖控制不佳）与颅内斑块特征之间的关系。
本研究共纳入 2017 年 12 月至 2019 年 3 月期间通过高分辨率 MRI 检测到颅内动脉粥样硬化斑块的 263 例患者（男性 182 例；平均年龄 62.6±11.5 岁）。患者分为不同组别：（i）有和无 2 型糖尿病的患者；（ii）血糖控制不佳（糖化血红蛋白水平≥7.0%）和血糖控制良好的糖尿病患者；以及（iii）糖尿病病程<5 年、5-10 年和>10 年的糖尿病患者。分别比较各组之间的斑块特征。
118 例（44.9%）患者被诊断为 2 型糖尿病。与非糖尿病患者相比，糖尿病患者强化斑块的发生率更高，最大斑块长度、最大管壁厚度更大，管腔狭窄更严重。与血糖控制良好的糖尿病患者相比，血糖控制不佳的糖尿病患者强化斑块的发生率更高，最大斑块长度更大（均 P<0.05）。不同病程的 2 型糖尿病患者的斑块特征无显著差异。在校正潜在混杂因素后，血糖控制不佳是斑块强化的独立因素（比值比 5.690；95%置信区间 1.748-18.526；P=0.004）。
2 型糖尿病与颅内斑块强化和负荷密切相关。最近血糖控制不佳可能在强化斑块的发展中起重要作用。
