title: Relevance of common carotid intima-media thickness and carotid plaque as risk factors for ischemic stroke in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  An increase in the common carotid artery intima-media thickness (CCA-IMT) is generally considered an early marker of atherosclerosis. This cross-sectional study assessed the CCA-IMT and plaque score as vascular risk factors in patients with ischemic stroke and type 2 diabetes.
  
  
  METHODS
  Brain MR imaging and carotid ultrasonography were performed in 133 subjects with type 2 diabetes. IMT was measured at both CCAs. Differences in the variables between case and control subjects were compared statistically. To determine the independent factors related to CCA-IMT and plaque score, we performed stepwise multiple regression analysis.
  
  
  RESULTS
  Sex, current smoking habit, history of hypertension, and high-density lipoprotein (HDL) levels differed significantly between the case and control groups. CCA-IMT and plaque score in patients with diabetes and acute ischemic stroke were significantly greater than in patients with diabetes who were stroke-free. The crude odds ratios suggested that CCA-IMT and plaque score are risk factors of acute ischemic stroke in patients with type 2 diabetes. However, when we adjusted for cerebrovascular risk factors, CCA-IMT and plaque score did not remain significantly associated with acute ischemic stroke.
  
  
  CONCLUSIONS
  Increased CCA-IMT and plaque score are associated with acute ischemic stroke in patients with type 2 diabetes. The higher CCA-IMT and plaque score found in ischemic stroke in patients with type 2 diabetes seem to be induced by cerebrovascular risk factors. Therefore, to prevent ischemic stroke in patients with type 2 diabetes, strict control of hyperglycemia, hypertension, smoking, and low HDL, together with monitoring of CCA-IMT and carotid plaque, may be important.
authors.affiliation: Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, Koyang, Korea. ejl1048@hanmail.net
authors.forename: E J
authors.initials: EJ
authors.lastname: Lee
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
authors.forename: J M
authors.initials: JM
authors.lastname: Bae
authors.forename: J C
authors.initials: JC
authors.lastname: Kim
authors.forename: H J
authors.initials: HJ
authors.lastname: Han
authors.forename: C S
authors.initials: CS
authors.lastname: Park
authors.forename: N H
authors.initials: NH
authors.lastname: Park
authors.forename: M S
authors.initials: MS
authors.lastname: Kim
authors.forename: J A
authors.initials: JA
authors.lastname: Ryu
mesh_terms: D000208:Acute Disease; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology*; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography