Background
The aim of our study was to evaluate the differences of prevalence and manifestation
of extracranial and intracranial artery stenosis between patients with and without
type 2 diabetes using digital subtraction angiography.
Methods
A retrospective study was conducted by analyzing clinical and lifestyle data collected
from 1137 patients enrolled in the Nanjing Stroke Registry Program between June 2004
and March 2011. Vascular risk factors were analyzed, and carotid and cerebrovascular
artery stenoses were measured in 383 patients with type 2 diabetes mellitus and 754
nondiabetic patients by digital subtraction angiography.
Results
In all, 1069 stenoses were found among 383 diabetic patients and 1990 among 754 nondiabetic
patients. No statistical differences were observed for the distribution of stenosis
in intracranial–extracranial vessels between diabetic and nondiabetic patients (P = .210). There was no difference in the distribution of stenosis in the anterior
and posterior circulation vessels between these 2 groups (P = .628). Among diabetic patients with stenosis, a single stenosis was found in 116
(30.29%) and multiple stenoses were found in 267 (69.71%). In their nondiabetic counterparts,
a single stenosis was found in 249 (33.02%) and multiple stenoses were found in 505
(66.98%). Compared with nondiabetic patients, the diabetic patients have a tendency
of a higher incidence of multiple stenosis. Nonobstructive stenosis occurs more often
in diabetic than in nondiabetic patients (P = .002).
Conclusions
This retrospective study suggests that diabetes be associated with higher incidence
of nonobstructive stenosis and that there be no significant difference observed in
the extent and distribution of the extra- and intracranial artery stenoses between
diabetic and nondiabetic patients.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diabetes and hypertension physiopathology and therapeutics.J Hum Hypertens. 2000; 14: S26-S31
- Heart disease and stroke statistics—2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.Circulation. 2008; 117: 25-146
- The IDF Diabetes Atlas: providing evidence, raising awareness and promoting action.Diabetes Res Clin Pract. 2010; 87: 2-3
- Prevalence of coronary artery disease and plaque morphology assessed by multi-slice computed tomography coronary angiography and calcium scoring in asymptomatic patients with type 2 diabetes.Heart. 2008; 94: 290-295
- Diabetes and stroke: part one: risk factors and pathophysiology.Curr Cardiol Rep. 2006; 8: 23-28
- The cost of diabetes in Latin America and the Caribbean.Bull World Health Organ. 2003; 81: 19-27
- Economic consequences of epidemiological changes in diabetes in middle-income countries.Diabetes Care. 2004; 27: 104-109
- Diabetes program in Malaysia—current and future.NCD Malaysia. 2004; 3: 6-12
- Long-term glycemic control relates to mortality in type II diabetes.Diabetes Care. 1995; 18: 1534-1543
World Health Organization. Diabetes action now booklet. A life-threatening condition. Available at: http://www.who.int/diabetes/BOOKLET_HTML/en/index3.html. Accessed September 19, 2005.
- Diabetes-associated macrovasculopathy: pathophysiology and pathogenesis.Diabetes Obes Metab. 2007; 9: 767-780
- Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms.Diabetes Care. 2007; 30: 3131-3140
- Beneficial effects of carotid endarterectomy in symptomatic patients with high grade carotid stenosis.N Engl J Med. 1991; 325: 445-453
- Impact of metabolic syndrome on prognosis of symptomatic intracranial atherosclerosis.Neurology. 2006; 66: 1344-1349
- Endothelial dysfunction in diabetic vasculopathy.Ann Biochem Res Educ. 2001; 1: 44-48
- Mechanisms of diabetic vasculopathy: an overview.Am J Hypertens. 2001; 14: 475-486
- Prevention and treatment of the complications of diabetes mellitus.N Engl J Med. 1995; 332: 1210-1217
- Prevalence and mortality of acute myocardial infarction in patients with diabetes.Diabetes Care. 1985; 8: 230-234
- Ten-year cardiovascular mortality in relation to risk factors and abnormalities in lipoprotein composition in type 2 (non-insulin-dependent) diabetic and non-diabetic subjects.Diabetologia. 1993; 36: 1175-1184
- An explanation for variations in distribution of stroke and arteriosclerotic heart disease among populations and racial groups.Am J Epidemiol. 1971; 93: 1-9
- Chinese–white differences in the distribution of occlusive cerebrovascular disease.Neurology. 1990; 40: 1541-1545
- Joint study of extracranial arterial occlusion. X. Internal carotid artery occlusion.JAMA. 1976; 235: 2734-2738
- Epidemiology.in: Kim J.S. Caplan L.R. Wong K.S. Intracranial atherosclerosis. Wiley-Blackwell, Hoboken, NJ2008: 33-44
- Epidemiology of intracranial stenosis.J Neuroimaging. 2009; 19: 11S-16S
- Cardiovascular complications in type 2 diabetes mellitus depend on the coronary angiographic state rather than on the diabetic state.Diabetologia. 2004; 47: 145-146
- Carotid artery intima–media thickness in patients with type 2 diabetes mellitus and impaired glucose tolerance: a systematic review.Diabet Med. 2006; 23: 609-616
Article info
Publication history
Published online: January 06, 2014
Accepted:
November 7,
2013
Received in revised form:
November 5,
2013
Received:
August 12,
2013
Footnotes
F.Y., L.L., W.X., and H.L. contributed equally to this work and share first authorship.
This study was partly supported by grants from the National Natural Science Foundation of China (no. 81201078, 81100870, 81000502) and the Hospital Foundation of Jinling Hospital (2011045).
Competing interests: The authors declare that they have no competing interests.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.005
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
