Correlation between asymptomatic intracranial arterial stenosis and carotid atherosclerosis in patients with Type 2 diabetes mellitus

Abstract

Objective To evaluate the correlation between asymptomatic intracranial arterial stenosis and extracranial carotid atherosclerosis in patients with Type 2 diabetes mellitus (DM). Methods Transcranial Doppler ultrasonography (TCD) and carotid ultrasonography were performed in 194 consecutive Type 2 DM patients who had no history of stroke to determine intracranial arterial stenosis and extracranial carotid atherosclerotic lesions. Extracranial carotid atherosclerotic lesions were divided into increased intima⁃media thickness (IMT), plaque and stenosis (≥ 50% stenosis or occlusion). The correlation between intracranial arterial stenosis and carotid atherosclerosis were assessed. Risk factors were also evaluated in the presence of intracranial arterial stenosis. Results Intracranial arterial stenosis (≥ 50% stenosis or occlusion) was found in 42 patients (21.65%). The middle cerebral artery (MCA) was involved in 30 patients (15.46%), which was the most affected intracranial artery. One hundred and twenty⁃three of 194 patients (63.40%) had extracranial carotid atherosclerosis. Age (t = ⁃ 3.054, P = 0.003), duration of DM (U = 2172.500, P = 0.002) and concomitant hypertension (χ2 = 9.986, P = 0.002) and carotid artery lesion (χ2 = 14.086, P = 0.000) in patients with intracranial arterial stenosis were significantly higher than those without intracranial arterial stenosis. The prevalence of intracranial arterial stenosis and middle cerebral artery (MCA) stenosis were correlated with the severity of carotid atherosclerosis (U = 1929.000, 1519.000, respectively; P = 0.000, for all). After adjustment for cerebrovascular risk factors, multivariate Logistic regression analysis showed that concomitant hypertension (OR = 2.849, 95% CI: 1.247-6.508; P = 0.013) and carotid artery lesion (OR = 4.838, 95% CI: 1.778-13.167; P = 0.002） were significant independent risk factors associated with asymptomatic intracranial arterial stenosis in Type 2 DM patients. Conclusion Asymptomatic intracranial arterial stenosis is correlated with carotid atherosclerosis in Type 2 DM patients, and extracranial carotid atherosclerosis may be an independent predictive factor for asymptomatic intracranial arterial stenosis in Chinese patients with Type 2 DM.

DOI：10.3969/j.issn.1672-6731.2010.03.016