Association between type 2 diabetes mellitus, especially recently uncontrolled glycemia, and intracranial plaque characteristics: A high-resolution magnetic resonance imaging study.

Publisher: Asian Association for the Study of Diabetes and Blackwell Pub. Asia Country of Publication: Japan NLM ID: 101520702 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2040-1124 (Electronic) Linking ISSN: 20401116 NLM ISO Abbreviation: J Diabetes Investig Subsets: MEDLINE

Original Publication: Tokyo : Asian Association for the Study of Diabetes and Blackwell Pub. Asia

Diabetes Mellitus, Type 2/*physiopathology ; Hyperglycemia/*complications ; Hypoglycemia/*complications ; Intracranial Arteriosclerosis/*pathology ; Magnetic Resonance Imaging/*methods; Female ; Follow-Up Studies ; Humans ; Intracranial Arteriosclerosis/etiology ; Male ; Middle Aged ; Prognosis ; Risk Factors

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.
Materials and Methods: 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.
Results: 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).
Conclusions: 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.
(© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

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Keywords: Diabetes mellitus; High-resolution magnetic resonance imaging; Intracranial atherosclerosis

Date Created: 20200227 Date Completed: 20210914 Latest Revision: 20240329

20240329

PMC7477510

10.1111/jdi.13239

32100945