Department of Hygiene, Wakayama Medical University, Wakayama, Japan.
Department of Neurology, University of Minnesota, MN, United States of America.
J Diabetes Complications. 2020 Sep;34(9):107605. doi: 10.1016/j.jdiacomp.2020.107605. Epub 2020 Apr 28.
The association of hyperglycemia and duration of diabetes with intracranial atherosclerotic stenosis (ICAS) in the general population is not well documented. We examined whether elevated glucose and longer diabetes duration is independently associated with ICAS in a community-based sample.
We cross-sectionally analyzed 1644 participants (age 67-90 years) of the Atherosclerosis Risk in Communities Study who underwent cerebrovascular magnetic resonance angiography in 2011-13. We applied multivariable ordinal logistic regression to evaluate the association of ICAS category ("no stenosis", "stenosis <50%", or "stenosis ≥50%") with glucose or diabetes duration (<10, 10 to 20, and ≥20 years). We also obtained the corresponding odds ratios applying inverse-probability weighting to account for potential selection bias due to attrition.
Compared to non-diabetic participants in the lowest glucose quartile, the weighted odds ratios (95% confidence interval) of higher ICAS category were 1.88 (1.18, 3.00) and 2.01 (1.08, 3.72) for non-diabetic and diabetic participants in the corresponding highest glucose quartile, respectively. We observed significant positive trends of ICAS across diabetes duration categories in unweighted, but not in weighted, analyses.
Hyperglycemia and longer duration of diabetes were independently associated with ICAS, suggesting the importance of maintaining glycemic control to prevent stroke.
高血糖和糖尿病病程与普通人群颅内动脉粥样硬化性狭窄（ICAS）的相关性尚未得到充分证实。我们研究了在基于社区的样本中，血糖升高和糖尿病病程延长是否与 ICAS 独立相关。
我们对 2011-2013 年接受过脑血管磁共振血管造影的动脉粥样硬化风险社区研究（Atherosclerosis Risk in Communities Study）的 1644 名（年龄 67-90 岁）参与者进行了横断面分析。我们应用多变量有序逻辑回归来评估 ICAS 类别（“无狭窄”、“狭窄<50%”或“狭窄≥50%”）与血糖或糖尿病病程（<10 年、10-20 年和≥20 年）之间的关系。我们还应用逆概率加权法获得了相应的优势比，以考虑由于失访导致的潜在选择偏差。
与血糖最低四分位的非糖尿病参与者相比，非糖尿病和相应最高血糖四分位的糖尿病参与者中，较高的 ICAS 类别的加权优势比（95%置信区间）分别为 1.88（1.18，3.00）和 2.01（1.08，3.72）。在未加权分析中观察到 ICAS 与糖尿病病程类别之间存在显著的正相关趋势，但在加权分析中则没有。
高血糖和较长的糖尿病病程与 ICAS 独立相关，提示控制血糖以预防中风的重要性。
