Newly-Diagnosed Disturbed Glucose Metabolism is Associated with Atherosclerosis in Patients with Transient Ischemic Attack or Ischemic StrokeSusanne Fonville1, Anouk C van Dijk1,2, Taihra Zadi2, Evita G van den Herik1, Hester F Lingsma3, Peter J Koudstaal1, Aad van der Lugt2 and Heleen M. den Hertog4
- *Corresponding Author:
- Susanne Fonville
Erasmus MC University Medical Center
Department of Neurology’s, Gravendijkwal 230
3015 CE Rotterdam, Netherlands
E-mail: [email protected]
Received date: December 09, 2014; Accepted date: January 22, 2015; Published : January 28, 2015
Citation: Fonville S, van Dijk AC, Zadi T, van den Herik EG, Lingsma HF, et al. (2015) Newly-Diagnosed Disturbed Glucose Metabolism is Associated with Atherosclerosis in Patients with Transient Ischemic Attack or Ischemic Stroke. J Diabetes Metab 6:496. doi: 10.4172/2155-6156.1000496
Copyright: © 2015 Fonville S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Newly-diagnosed disturbed glucose metabolism is highly prevalent in non-diabetic patients with transient ischemic attack (TIA) or ischemic stroke, and increases the risk of recurrent stroke. Diabetes mellitus is associated with atherosclerosis. We aimed to assess whether newly-diagnosed disturbed glucose metabolism is associated with atherosclerosis as well.
Research design and methods: Patients with a recent TIA or ischemic stroke were classified in three groups based on glucose levels and use of antidiabetic drugs. Pre-existent diabetes mellitus was defined as the use of antidiabetic drugs prior to the event. Newly-diagnosed disturbed glucose metabolism was defined as two or more disturbed glucose tests: fasting plasma glucose level ≥ 5.6 mmol/L, 2-hour post-load glucose level ≥ 7.8 mmol/L, and/or glycosylated hemoglobin level ≥ 39 mmol/mol. We used CT-angiography to assess stenosis in the carotid artery bifurcations and calcification volume in the aortic arch, carotid bifurcations and intracranial carotid arteries. The relation between glucose groups and measures of atherosclerosis was expressed as odds ratios and beta coefficients with corresponding 95% CI, adjusted for potential confounders. Results: Of the 1217 patients, 384 (32%) had newly-diagnosed disturbed glucose metabolism, and 210 (17%) had pre-existent diabetes mellitus. Newly-diagnosed disturbed glucose metabolism was independently associated with stenosis ≥ 50% (aOR (95%CI) 1.15 (1.04-2.20)). Pre-existent diabetes mellitus was associated with stenosis ≥ 50% and with calcification volume in all regions, especially in patients without the use of cholesterol-lowering drugs prior to the event.
Conclusions: Our study shows that newly-diagnosed disturbed glucose metabolism in patients with a recent TIA or ischemic stroke is associated with more severe extra- and intracranial atherosclerosis, similar to pre-existent diabetes mellitus.