Glucose Fluctuation and Severe Internal Carotid Artery Siphon Stenosis in Type 2 Diabetes Patients.

Futoshi Eto,Masaki Matsubara,Hisashi Makino,Kunihiro Nishimura,Masafumi Ihara,Kiminori Hosoda,Yuriko Nakaoku,Kotaro Noda,Kazuo Washida,Akio Takahashi,Yorito Hattori

doi:10.3390/nu13072379

Futoshi Eto, Masaki Matsubara + Show 9 more

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https://doi.org/10.3390/nu13072379

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Journal: Nutrients	Publication Date: Jul 12, 2021
Citations: 7	License type: CC BY 4.0

Affiliation: National Cerebral and Cardiovascular Center

Abstract

The impact of glucose fluctuation on intracranial artery stenosis remains to be elucidated. This study aimed to investigate the association between glucose fluctuation and intracranial artery stenosis. This was a cross-sectional study of type 2 diabetes mellitus (T2DM) patients equipped with the FreeStyle Libre Pro continuous glucose monitoring system (Abbott Laboratories) between February 2019 and June 2020. Glucose fluctuation was evaluated according to the standard deviation (SD) of blood glucose, coefficient of variation (%CV), and mean amplitude of glycemic excursions (MAGE). Magnetic resonance angiography was used to evaluate the degree of intracranial artery stenosis. Of the 103 patients, 8 patients developed severe internal carotid artery (ICA) siphon stenosis (≥70%). SD, %CV, and MAGE were significantly higher in the severe stenosis group than in the non-severe stenosis group (<70%), whereas there was no significant intergroup difference in the mean blood glucose and HbA1c. Multivariable logistic regression analysis adjusted for sex showed that SD, %CV, and MAGE were independent factors associated with severe ICA siphon stenosis. In conclusion, glucose fluctuation is significantly associated with severe ICA siphon stenosis in T2DM patients. Thus, glucose fluctuation can be a target of preventive therapies for intracranial artery stenosis and ischemic stroke.

Highlights

Academic Editor: Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Abstract: The impact of glucose fluctuation on intracranial artery stenosis remains to be elucidated
The severe stenosis group showed significantly higher standard deviation (SD) (OR, 3.60; 95% confidence interval (CI), 1.60–8.08; p < 0.01), %coefficient of variation (CV) (OR, 7.85; 95% CI, 1.90–32.5; p < 0.01), and mean amplitude of glycemic excursions (MAGE)
Multivariable logistic regression analysis showed that these factors remained significantly associated with severe internal carotid artery (ICA) siphon stenosis after adjustment for sex (SD: odds ratio (OR), 3.00; 95% CI, 1.32–6.84; p < 0.01; %CV: OR, 5.55; 95% CI, 1.23–25.2; p = 0.03; and MAGE: OR, 1.52; 95% CI, 1.06–2.19; p = 0.02) (Table 2)

Summary

Introduction

This study aimed to investigate the association between glucose fluctuation and intracranial artery stenosis. Glucose fluctuation is significantly associated with severe ICA siphon stenosis in T2DM patients. Glucose fluctuation can be a target of preventive therapies for intracranial artery stenosis and ischemic stroke. Some studies reported that elevated hemoglobin A1c (HbA1c) and fasting blood glucose levels are associated with intracranial artery stenosis [6], others showed no correlations [7]. The usefulness of HbA1c and fasting blood glucose levels as predictors of intracranial artery stenosis remains unclear. There are various indicators for blood glucose control in patients with DM; these include hemoglobin A1c (HbA1c) and glycoalbumin These indicators only reflect the mean blood glucose level for a certain period and cannot reflect glucose fluctuation

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