Risk factors for middle cerebral artery stenosis in Chinese patients with type 2 diabetes mellitus

Objective: To investigate the risk factors for middle cerebral artery (MCA) stenosis in Chinese patients with type 2 diabetes mellitus. Methods: An age, gender and duration of diabetes frequency-matched case-control study was carried out. All 2202 consecutive type 2 diabetic patients were examined by using transcranial Doppler (TCD). MCA stenosis was diagnosed as the peak systolic flow velocity of MCA was greater than 140 cm/s. Out of the 2202 diabetic patients without stroke or TIA, 292 were excluded from this study because it was not possible for insonation of the cerebral arteries through the temporal window, and 389 patients with MCA stenosis were identified, the other 1521 diabetic patients were considered as controls. The medical history and measurement of anthropometric and biochemical parameters were taken. X² test, t-test and Logistic regression analysis were used for determining the predictors of MCA stenosis. Results: Both the rates of diagnosis (case 76.8% vs control 53.4%) and treatment (51.5% vs 26.6%) of hypertension were higher in patients with MCA stenosis, as was the rate of albuminuria(41.1% vs 30.1%). Patients with MCA stenosis had an elevated systolic (147 mm Hg vs 138 mm Hg), but a lower diastolic (81 vs 84 mm Hg) blood pressure than those without MCA stenosis. Patients with MCA stenosis had a significant increase in albumin-to-creatinine ratio (ACR) (5.9 vs 3.5 mg/mmol) and LDL-cholesterol (3.8 vs 3.6 mmol/L), but a decrease in glucose levels (8.1 vs 8.7 mmol/L) than those without MCA stenosis. Age, gender, duration of diabetes, and the parameters related to MCA stenosis in the frequency-matched group, including hypertensive status, treatment of hypertension, systolic blood pressure, diastolic blood pressure, glucose level, and LDL-cholesterol, were included in logistic regression analysis to determine the independent predictors of MCA stenosis, and consequently the age, hypertension, LDL-cholesterol were found to be the independent predictors for MCA stenosis. Conclusion: Age, hypertension, LDL-cholesterol should be the risk factors for MCA stenosis.