Recently Uncontrolled Glycemia in Diabetic Patients Is Associated with the Severity of Intracranial Atherosclerosis

Choi, Nag-Choul; Lee, Jeong-Yoon; Sunwoo, Jun Sang; Roh, Hee-Tae; Ahn, Moo-Young; Park, Sung‐Tae; Lee, Kyung Bok

doi:10.1016/j.jstrokecerebrovasdis.2017.06.025

Cited by 12 publications

(12 citation statements)

References 42 publications

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“…The result from the present study could be explained as follows: (i) some participants did not know the exact duration of their type 2 diabetes mellitus; (ii) we did not assess all the intracranial artery lesions, just the most serious lesion for each patient; and (iii) there is a possibility that the role of the duration of type 2 diabetes mellitus is less important for intracranial atherosclerosis than it is for the extracranial arteries. A similar finding was reported that the duration of type 2 diabetes mellitus was not significantly associated with the severity of intracranial atherosclerosis 22 .…”

Section: Discussionsupporting

confidence: 87%

“…Type 2 diabetes mellitus is independently related to a greater degree of intracranial atherosclerosis and a higher number of involved vessels 21 . Most of the previous studies evaluated the severity of intracranial atherosclerosis with MRA by the pattern of intracranial stenosis and the number of vessels with significant stenosis 22 . In the present study, instead of using MRA or CTA to assess the severity of intracranial atherosclerosis, we used HR-MRI to evaluated intracranial plaque burden and stability more directly and accurately, and studied its relationship with type 2 diabetes mellitus, which has seldom been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Glycemic level is closely related to carotid atherosclerosis shown by luminal stenosis and intima-media thickness 26 . Recently, it was reported that uncontrolled glycemia in diabetes patients is related to the severity of intracranial atherosclerosis evaluated using MRA 22 . So far, there are few studies on the relationship between uncontrolled glycemia and intracranial plaque vulnerability.…”

Section: Discussionmentioning

confidence: 99%

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

Huang

Jiao

Song

et al. 2020

J of Diabetes Invest

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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.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Huang

Jiao

Song

et al. 2020

J of Diabetes Invest

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“…Patients with higher ICAS were associated with the worst outcome [17]. Previous study suggested that exposure to hyperglycemia accelerated ICAS, which may cause ACI [18]. Therefore, we speculate that ACI and hyperglycemia play a synergistic role in recanalization, and controlling GLU will be an important factor affecting recanalization.…”

Section: Discussionmentioning

confidence: 72%

Influencing Factors of Recanalization after Intravenous Thrombolysis with Urokinase in Acute Cerebral Infarction Patients

et al. 2020

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Background: Intravenous thrombolysis (IVT) with urokinase is the standard reperfusion therapy for acute cerebral infarction (ACI) in China. Only about 30% patients who use urokinase for IVT can recanalize. Therefore, this study aimed to analyze the influencing factors of recanalization after IVT using urokinase in ACI patients. Methods: A total of 391 consecutive patients with a diagnosis of ACI from January 2013 to October 2019 were enrolled and divided into 2 groups: patients without recanalization and patients with recanalization. Related data were collected and analyzed. Results: Univariate analysis showed that there were significant differences in gender, atrial fibrillation, erythrocyte mean corpuscular volume, platelet large cell ratio (P-LCR), glucose (GLU), and severity of ICAS between patients without recanalization and patients with recanalization (p < 0.05). Multivariate logistic regression analysis indicated that P-LCR (odds ratio [OR] = 0.17, 95% confidence interval [CI] = 0.03–0.89, p = 0.04), GLU (OR = 0.28, 95% CI = 0.11–0.67, p = 0.004), and ICAS severity (OR = 0.48, 95% CI = 0.32–0.76, p = 0.001) were the influencing factors of recanalization. Conclusion: For patients with higher levels of P-LCR, GLU, or ICAS severity, the recanalization rate might decrease after ACI.

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“…Atherosclerosis, a progressive pathological disorder inducing cardiovascular and cerebrovascular diseases, is a leading cause of human morbidity and mortality worldwide (Phrommintikul et al., ). This global health burden remains high due to the increased incidence of traditional atherosclerosis risk factors, such as hypertension and type 2 diabetes (Biessen & Wouters, ; Choi et al., ; Phrommintikul et al., ). Atherosclerosis arises from leukocyte infiltration, plaque formation, and thickening of the vessel walls (Dutta et al., ).…”

Section: Introductionmentioning

confidence: 99%

Curcumin suppresses pro-inflammatory adhesion response in Human Umbilical Vein Endothelial Cells

Chang

Cheng

2018

J Food Biochem

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Atherosclerosis, a progressive pathological disorder, is a leading cause of human morbidity and mortality worldwide. The expression of cell adhesion molecules by the endothelium and the attachment of monocytes to endothelium may play a pivotal role in the early atherogenic process. Curcumin, a polyphenol obtained from the root of turmeric, is the main component of curry powder. Previous studies indicated that curcumin exhibits a variety of pharmacological effects, including anti‐inflammatory, antitumor, antioxidant, and anti‐hypertensive properties. In the current study, we found that curcumin could suppress the IL‐1β‐induced intracellular reactive oxygen species production and the activation of redox‐sensitive transcription factors NF‐κB p50 and p65. Moreover, curcumin could inhibit the expression of adhesion molecules, including intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), and E‐selectin, and further decrease the adhesiveness to a human monocytic cell line (U937) in human umbilical vein endothelial cells (HUVECs). These findings may identify the novel role and potential translational application of curcumin, suggesting its potential applicability as an anti‐atherosclerotic agent. Practical applications In the current study, we examine the inhibitory effects of curcumin on monocyte adhesion to cultured human endothelial cells and the expression of adhesion molecules by IL‐1β in HUVECs and elucidate its possible mechanism of action. Our findings may identify the novel role and potential translational application of curcumin, suggesting its potential applicability as an anti‐atherosclerotic agent.

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Recently Uncontrolled Glycemia in Diabetic Patients Is Associated with the Severity of Intracranial Atherosclerosis

Cited by 12 publications

References 42 publications

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

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

Influencing Factors of Recanalization after Intravenous Thrombolysis with Urokinase in Acute Cerebral Infarction Patients

Curcumin suppresses pro-inflammatory adhesion response in Human Umbilical Vein Endothelial Cells

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