The Brainstem Is at High Risk for Recurrent Noncardioembolic Cerebral Infarction in Association with Diabetes Mellitus: A Hospital-Based Study

Abstract

The goals of the study were to investigate the importance of brainstem infarction (BSI) in recurrent noncardioembolic ischemic stroke and to examine the relevant clinical background. Data were retrospectively reviewed for 655 consecutive patients with acute noncardioembolic infarction who were admitted to our hospital from January 2004 to August 2010. The patients were divided into first-stroke (n = 592) and recurrent-stroke (n = 63) groups. Acute infarcted lesions were explored on MRI, and clinical background factors including age, sex, smoking, atrial fibrillation, coronary heart disease, hypertension, hyperlipidemia and diabetes mellitus (DM) were assessed. The frequency of BSI in the recurrent-stroke group was significantly higher than that in first-stroke patients (30.2 vs. 14.9%, p = 0.0033). No other clinical background factors differed between the two groups. Only the frequency of DM differed significantly among four subgroups formed based on stroke recurrence and BSI (p < 0.0001): DM was present in 63.2% of recurrent-stroke patients with BSI, 54.5% of first-stroke patients with BSI, 27.4% of first-stroke patients without BSI, and 20.5% of recurrent-stroke patients without BSI. We conclude that the brainstem is at high risk for recurrent cerebral infarction in patients with DM.

Curcumin improves diabetes mellitus‑associated cerebral infarction by increasing the expression of GLUT1 and GLUT3

“…The main risks of diabetes are chronic complications caused by chronic hyperglycemia, and some of the most important complications are vascular complications (3,6). It is reported that 75% of diabetic patients worldwide succumbed to diabetic vascular complication-associate mortality, and this mortality rate ranks as the second highest of total causes of diabetes-associated mortality (7,23).…”

“…Diabetic cerebrovascular disease is mainly caused by diabetic cerebral infarction, which accounts for 85% of diabetic cerebrovascular disease (8,25). The prevalence of the diabetic vascular disease rate increases with increasing duration of diabetes, ischemic lesions rather than hemorrhagic lesions, particularly in lacunar infarction, and due to repeated relapse of the disease, therefore, the prevention and cure of cerebral infarction is key to reducing diabetes morbidity rates (5,6).…”

“…With improved living conditions, dietary changes and reduced labor intensity, the incidence of diabetes mellitus is rapidly increasing worldwide (1)(2)(3). Diabetic patients with poor glucose control can experience multiple complications, including cardiovascular disease, kidney disease, blindness and amputation, which not only seriously affects the quality of life of patients, but also imposes a heavy burden on family and society (4)(5)(6). Cerebral infarction is one of the major complications and one of the main causes of mortality associated with diabetes (5).…”

“…Cerebral infarction is one of the major complications and one of the main causes of mortality associated with diabetes (5). Previous studies have shown that diabetes is one of the independent risk factors of stroke; diabetic patients succumb to cerebrovascular complication-associated mortality more frequently, compared with non-diabetic patients (3,6,7). Therefore, the prevention and treatment of diabetes complicated by cerebral infarction requires investigation to reduce the mortality and disability rates of patients.…”

Glycated Hemoglobin Independently Predicts Stroke Recurrence within One Year after Acute First-Ever Non-Cardioembolic Strokes Onset in A Chinese Cohort Study

“…The candidate variables that were entered into the multivariate analysis were based on newly prior published, traditionally or clinically associated with stroke (mainly focused on stroke recurrence), or P<0.10 in the univariate analysis. After a selection of all the variables (detailed in Text S2 ), the variables entered into the multivariate analysis were: age, gender, education status received, tobacco use, alcohol consumption, systolic and diastolic pressure at baseline and discharge [ 21 ], BMI and waist circumference [ 22 ], history of coronary heart disease, history of hypertension and history of family stroke [ 22 , 23 ], history of diabetes, ischemic stroke subtypes [ 24 ], OCSP subtypes [ 25 ], HOMA [ 26 ], uric acid [ 27 ], homocysteine [ 28 ], creatinine [ 29 ], high density lipoprotein [ 29 ], low density lipoprotein [ 22 ], triglyceride and cholesterol [ 22 ], FPG, medication therapy (antithrombotic, antihypertensive and lipid-lowering medications) during hospitalization and medication adherence (antithrombotic, antihypertensive and lipid-lowering medications) during follow-up. In the multivariate analysis, gender, tobacco use, alcohol intake, family history of stroke, past medical history of hypertension and coronary heart disease, TOAST and OCSP subtypes, medications’ information, and HbA1c were entered as categorical variables.…”