Diabetes mellitus contributes to cerebral infarction by promoting carotid artery plaque formation / 中华神经医学杂志

ABSTRACT

Objective To investigate the relation between cerebral infarction and both diabetes mellitus and carotid artery plaque. Methods Two hunderd and twenty-six patients with ischemic cerebral vascular diseases were chosen in our study; MRI was employed to determine whether new infarction existed or not; carotid artery plaque positive group and negative group were divided according to the carotid artery intima-media thickness(IMT) examined by carotid ultrasound; the gender,age and biochemical markers of these patients,and their coexistence of hypertension and diabetes mellitus were recorded.The positive rates of cerebral infarction,carotid artery plaque and diabetes mellitus were noted and analyzed by binary comparison, and the level-risk relation were analyzed by logistic regression.Results The positive rate of carotid artery plaque in patients with cerebral infarction (84％) was significantly higher as compared with that in patients without cerebral infarction (52％),and the positive rate of cerebral infarction in patients with carotid artery plaque (66％) was obviously higher as compared with that in patients without carotid artery plaque (28％); correlation analysis between cerebral infarction and carotid artery plaque through logistic regression showed that the OR value and 95％CI were 5.019and (2.694-9.354) before adjustment,and 4.459 and (2.061-9.647) after adjustment (P＜0.05).The positive rate of diabetes mellitus in patients with carotid artery plaque (38％) was significantly higher as compared with that in patients without carotid artery plaque (13％),and the positive rate of carotid artery plaque in patients with diabetes mellitus (87％) was obviously higher as compared with that in patients without diabetes mellitus (62％) ; correlation analysis between diabetes mellitus and carotid artery plaque through logistic regression showed that the OR value and 95％CI were 4.010 and (1.854-8.672) before adjustment,and 4.272 and (1.565-11.662) after adjustment (P＜0.05).The positive rate of diabetes mellitus in patients with cerebral infarction (38％) was significantly higher as compared with that in patients without cerebral infarction (21％),and the positive rate of cerebral infarction in patients with diabetes mellitus (68％) was significantly higher as compared with that in patients without diabetes mellitus (48％,P＜0.05); correlation analysis between diabetes mellitus and cerebral infarction through logistic regression showed that the OR value and 95％ CI were 2.256 and (1.242-4.095) before adjustment,and 2.256 and (1.242-4.095) after adjustment; when the carotid artery plaque was added in procedure of adjustment (P＜0.05),the results of OR value and 95％CI were 1.696 and (0.833-3.452),and no significant difference in the positive rate of cerebral infarction was noted between patients with diabetes mellitus and cerebral infarction (P＞0.05). Conclusion Diabetes mellitus contributes to cerebral infarction by promoting carotid artery plaque formation.