Correlation between brainstem infarction and diabetes

Abstract

Objective To investigate the correlation between diabetes and brainstem infarction. Methods The diagnozed patients with acute cerebral infarction were recruited in the study. Firstly, they were divided into brainstem infarction group and non-brainstem infarction group, and then they were redivided into brainstem infarction with diabetes, brainstem infarction without diabetes, non-brainstem infarction with diabetes and non-brainstem infarction without diabetes groups according to whether they had thickness （IMT） and carotid atherosclerosis diabetes or not. Carotid artery intima-media were detected and identified with Doppler ultrasound; brain stem infarction and its location were identified with diffusion-weighted imaging;basilar artery atherosclerosis was detected with magnetic resonance angiography （MRA）. A mult ivariate logistic regression analysis was used to screen the different risk factors impacting brainstern infarction. Neurological deficit was evaluated with the modified Rankin Scale （mRS） scores. Results A total of 286 patients with acute cerebral infarction were recruited： brain stem infarction in 63, and 34 of them with diabetes; non-brain stem infarction in 223, and 77 of them with diabetes. The proportions of diabetes （54.0% vs. 34. 5%, ）t＂2 = 7. 816, P = 0. 005）, previous cerebral infarction （38. 1% vs. 24. 2%,X2 -4. 771, P=0. 029）, basilar artery athero- sclerosis （73.0% vs. 57.4% ,X2 =5. 028, P =0. 025）, as well as the levels of hemoglobin A1C （HbAlc） （7. 30 ±2.42% vs. 6. 46 - 1.82%, t = -2. 531, P = 0. 011） and apolipoprotein B （ApoB） （0.97±0.33 mmol/Lvs. 0.90±0.34retool/L, t=-2. 180, P=0.029） in the brainstern infarction group were significantly higher than those in the non-brainstem infarction group. Multivariate logistic regression analysis showed that diabetes （odds ratio [ OR ] 2. 150, 95% confidence interval E Cll 1. 21±3. 808; P - 0. 009） and previous cerebral infarction （OR 1. 835, 95% C1 1. 004-3. 352, P = 0. 048） were the independent risk factors for brainstem infarction. There were significant differences in the levels of HbAlc （P 〈0. 001）, fasting blood glucose （FBG） （P 〈0. 001）, ApoB （P =0. 007） and high-density lipoprotein cholesterol （P = 0. 018） as well as the proportion of basilar artery atherosclerosis （P = 0. 001 ） among the brainstem infarction with diabetes, without diabetes, non-brainstem infarction with diabetes and without diabetes groups. The levels of HbAlc （8. 81 ±2. 36%）, FBG （8.23±3. 12 mmol/L and ApoB （1.04 -0. 41 retool/L） as well as the proportion of basilar artery atherosclerosis （85.3%） were the highest in the brainstem infarction with diabetes group. Conclusions Diabetes is closely associated with brainstem infarction. Diabetes is more likely to result in pontine infarction. Key words: Diabetes mellitus; Brain stern infarctions; Brain infarction; Magnetic resonance imaging; Risk factors