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American Journal of Neuroradiology 28:916-919, May 2007
© 2007 American Society of Neuroradiology

BRAIN

Relevance of Common Carotid Intima-Media Thickness and Carotid Plaque as Risk Factors for Ischemic Stroke in Patients with Type 2 Diabetes Mellitus

E.J. Leea, H.J. Kimb, J.M. Baed, J.C. Kime, H.J. Hanc, C.S. Parka, N.H. Parka, M.S. Kima and J.A. Ryua

a Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, Koyang, Korea
b Department of Endocrinology, Myongji Hospital, Kwandong University, College of Medicine, Koyang, Korea
c Department of Neurology, Myongji Hospital, Kwandong University, College of Medicine, Koyang, Korea
d Department of Preventive Medicine, Cheju National University, College of Medine
e Department of Radiology, Chungnam National University College of Medicine

Address correspondence to Eun Ja Lee, MD, Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, 697-24, Hwajung-Dong, Dukyang-Gu, Koyang-City, Gyunggi-Do, 412-270, Republic of Korea; e-mail: ejl1048{at}hanmail.net

BACKGROUND AND PURPOSE: An increase in the common carotid artery intima-media thickness (CCA-IMT) is generally considered an early marker of atherosclerosis. This cross-sectional study assessed the CCA-IMT and plaque score as vascular risk factors in patients with ischemic stroke and type 2 diabetes.

MATERIALS AND METHODS: Brain MR imaging and carotid ultrasonography were performed in 133 subjects with type 2 diabetes. IMT was measured at both CCAs. Differences in the variables between case and control subjects were compared statistically. To determine the independent factors related to CCA-IMT and plaque score, we performed stepwise multiple regression analysis.

RESULTS: Sex, current smoking habit, history of hypertension, and high-density lipoprotein (HDL) levels differed significantly between the case and control groups. CCA-IMT and plaque score in patients with diabetes and acute ischemic stroke were significantly greater than in patients with diabetes who were stroke-free. The crude odds ratios suggested that CCA-IMT and plaque score are risk factors of acute ischemic stroke in patients with type 2 diabetes. However, when we adjusted for cerebrovascular risk factors, CCA-IMT and plaque score did not remain significantly associated with acute ischemic stroke.

CONCLUSION: Increased CCA-IMT and plaque score are associated with acute ischemic stroke in patients with type 2 diabetes. The higher CCA-IMT and plaque score found in ischemic stroke in patients with type 2 diabetes seem to be induced by cerebrovascular risk factors. Therefore, to prevent ischemic stroke in patients with type 2 diabetes, strict control of hyperglycemia, hypertension, smoking, and low HDL, together with monitoring of CCA-IMT and carotid plaque, may be important.






Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X