【摘 要】
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OBJECTIVE: High levels of hemoglobin A1c (HbA1c) have been associated with increased risk of atherosclerosis assessed as carotid intima-media thickness by ultrasound; however, the association between
【机 构】
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Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 160 Pujia
【出 处】
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中华放射学学术大会2016、中华医学会第23次全国放射学学术大会暨中华医学会第24次全国影像技术学术大会
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OBJECTIVE: High levels of hemoglobin A1c (HbA1c) have been associated with increased risk of atherosclerosis assessed as carotid intima-media thickness by ultrasound; however, the association between HbA1c level and carotid plaque composition rarely has been studied by magnetic resonance imaging (MRI). The present study of MR-identified carotid atherosclerotic lesions in hypertensive patients with acute stroke therefore sought to determine the associations between HbA1c level and plaque morphological and compositional characteristics and acute cerebral infarction (ACI) severity. METHODS: Eighty patients with acute stroke and hypertension (46.3% with history of type 2 diabetes mellitus, and 63.8% with symptomatic carotid plaque) were enrolled; stratified into high (≥6.5) and low (<6.5%) HbA1c groups; and underwent carotid and brain MR with diffusion-weighted imaging (DWI) to assess carotid plaque features and ACI volume in the region supplied by the internal carotid artery (ICA) in the symptomatic side. RESULTS: Plaque burden [percent wall volume (PWV), max wall thickness (max-WT)] and lipid rich necrotic core (LRNC) were larger in the high as compared to the low HbA1c group. In multivariate logistic regression analysis, high HbA1c was an independent risk factor for the presence of plaque (odds ratio [OR]=3.71, P=0.046) and LRNC plaque (OR=7.08, P=0.002). In multiple linear regression analysis, HbA1c independently correlated ( =0.37, P= 0.002) with ACI severity among patients with ICA region cerebral infarction and carotid plaque. CONCLUSIONS: Elevated HbA1c level is closely related to carotid plaque characteristics, particularly plaque burden (PWV, max-WT) and LRNC composition by MRI, and independently correlated with ACI severity. HbA1c level determination therefore might be useful for stratification of plaque risk and cerebral infarction severity.
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