Cerebral arterial pulsatility and insulin resistance in type 2 diabetic patients.
Diabetic patients have a threefold risk for cerebrovascular disease compared with nondiabetic controls. The aim of the present study was to investigate the association of insulin resistance with the pulsatility index (PI) of cerebral arteries in type 2 diabetic patients. We compared a group of 90 patients with stroke-free, type 2 diabetes and an age- and sex-matched control group of 45 healthy subjects without diabetes. We then evaluated the PI of the middle cerebral artery (MCA) by transcranial Doppler ultrasonography (TCD), and insulin resistance was determined by a short insulin tolerance test. The PI was significantly higher in diabetic patients than in healthy controls (p<0.05) and also higher in patients with insulin resistance than that seen in insulin sensitive diabetic patients (p<0.05). The PI of the MCA was significantly correlated with age (R=0.465, p<0.01), duration of diabetes (R=0.264, p=0.025) and hypertension (R=0.285, p=0.015) and inversely correlated with the insulin resistance index (Kitt: R=-0.359, p=0.030). A multiple regression analysis was performed with PI as the dependent variable and insulin resistance as an independent variable along with known clinical risk factors. Age (beta=0.393, p<0.01) and duration of diabetes (beta=0.274, p=0.043) exhibited a significant independent contribution to PI. PI could be a useful marker in the detection of diabetic cerebrovascular changes, and insulin resistance showed correlations with PI, but age and the duration of diabetes contributed independently to the variability in the PI.
Park
Jong Suk
JS
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Cho
Min Ho
MH
Lee
Kyung Yul
KY
Kim
Chul Sik
CS
Kim
Hai Jin
HJ
Nam
Ji Sun
JS
Ahn
Chul Woo
CW
Cha
Bong Soo
BS
Lee
Eun Jig
EJ
Lim
Sung Kil
SK
Kim
Kyung Rae
KR
Lee
Hyun Chul
HC
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006400:Hematocrit; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000502:physiology / Q000503:physiopathology*; D018579:Patient Selection; D011674:Pulse; D012016:Reference Values
D006442:Glycated Hemoglobin; D008055:Lipids