Impacts of Glycemic Control on Intracranial Plaque in Patients with Type 2 Diabetes Mellitus: A Vessel Wall MRI Study

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FIG 1.
Flow diagram of study identification.
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FIG 2.
Strong enhancement of plaque in the MCA. A, TOF-MRA shows severe stenosis in the M1 segment of the left MCA (arrow). B, Postcontrast T1-weighted image (axial acquisition) shows wall thickening at the corresponding location (arrow). C, Reconstructed T1-weighted image shows the length of plaque (arrow) in the long axis of the MCA at the site of the most stenotic lesion. D, Reconstructed T1-weighted image shows the thickness of plaque (arrow) in the short axis of the MCA at the site of the most stenotic lesion.

Table 1:

Clinical characteristics among NDM, DMGGC, and DMPGC groups^{^a}

	NDM Group (n = 172)	DMGGC Group (n = 55)	DMPGC Group (n = 84)	χ²/F	P Value
Male (No.) (%)	117 (68.02)	44 (80)	56 (66.67)	3.362	.186
Age (yr)	62.44 ± 11.87	63.71 ± 9.90	64.60 ± 11.47	1.061	.347
BMI (Kg/m²)	25.66 ± 3.37	25.60 ± 3.00	25.50 ± 3.37	0.066	.936
Smoking (No.) (%)	73 (42.44)	19 (34.55)	36 (42.86)	1.210	.546
Hypertension (No.) (%)	129 (75)	48 (87.28)	69 (82.14)	4.441	.109
Grade 1 hypertension (No.) (%)	90 (69.77)	37 (77.08)	52 (75.36)	1.271	.530
Grade 2 hypertension (No.) (%)	39 (30.23)	11 (22.92)	17 (24.64)
BP uncontrolled (No.) (%)	84 (65.12)	36 (75)	50 (72.5)	2.107	.349
History of CAD (No.) (%)	25 (14.53)	15 (27.27)	17 (20.24)	4.798	.091
Family history of CVD (No.) (%)	22 (12.79)	5 (9.09)	9 (10.71)	0.641	.726
Hyperlipemia (No.) (%)	111 (64.53)	37 (67.27)	47 (55.95)	2.375	.305
Total cholesterol (mmol/L)	3.81 (3.10–4.70)	3.24 (2.94–4.48)	3.35 (2.96–4.22)	5.946	.051
LDL (mmol/L)	2.22 (1.67–2.93)	1.81 (1.48–2.81)	2.07 (1.58–2.63)	4.918	.086
HDL (mmol/L)	1.00 (0.89–1.15)^{^b}	0.99 (0.87–1.19)	0.92 (0.76–1.09)^{^b}	9.796	.008
Triglycerides (mmol/L)	1.37 (0.97–1.93)	1.16 (0.90–1.82)	1.32 (0.96–1.82)	1.749	.417
LDL/HDL ratio	2.12 (1.64–2.93)	1.81 (1.53–2.40)	2.21 (1.77–2.87)	4.565	.102

Note:—DMGGC indicates T2DM with good glycemic control; DMPGC, T2DM with poor glycemic control; BMI, body mass index; LDL, low-density lipoprotein cholesterol; HDL, high-density lipoprotein cholesterol; CAD, coronary artery disease; CVD, cardiovascular disease; BP, blood pressure.
↵a Continuous variables with normal distribution are presented as means ± SD; continuous variables with non-normal distribution are presented as median (25th–75th percentiles); and categoric variables are presented as (No.) (%).
↵b P value < .05.

Table 2:

The characteristics of intracranial plaque among NDM, DMGGC, and DMPGC groups^{^a}

	NDM Group (n = 172)	DMGGC Group (n = 55)	DMPGC Group (n = 84)	χ²	P Value
Plaque length (mm)	4.90 (3.43–7.58)^{^b}	6.10 (3.70–8.00)	6.45 (4.63–10.95)^{^b}	19.086	<.001
Plaque thickness (mm)	1.40 (1.10–2.18)^{^b}	1.60 (1.20–2.20)	1.80 (1.40–2.38)^{^b}	10.043	.005
Lumen stenosis (%)	38.52 (16.67–72.67)^{^b}	54.83 (39.29–72.41)	66.67 (34.47–80.15)^{^b}	17.757	<.001
Strong enhancement (No.) (%)	109 (63.37)	40 (72.73)		1.617	.203
	109 (63.37)^{^b}		78 (92.86)^{^b}	24.921	<.001
		40 (72.73)^{^b}	78 (92.86)^{^b}	10.501	.001

Note:—DMGGC indicates T2DM with good glycemic control; DMPGC, T2DM with poor glycemic control.
↵a Continuous variables with non-normal distribution are presented as median (25th–75th percentiles); categoric variables are presented as (No.) (%).
↵b P value < .05.

Table 3:

Association between risk factors of cardiovascular disease and heavy burden and vulnerability of intracranial plaques

Note:—LDL indicates low-density lipoprotein cholesterol; HDL, high-density lipoprotein cholesterol.
↵a Multivariate logistic regression adjusted for age, smoking, hypertension, history of coronary artery disease, and family history of cardiovascular disease.