Relation Between Impaired Glucose Tolerance And Atherosclerosis In Patients With Cerebral Infarction

Objective:By comparing biochemical indicators and carotid atherosclerotic plaque of patients with cerebral infarction of three groups, to analyze the possible effect of impaired glucose tolerance on patients with cerebral infarction.Methods:In September2011to September2012,221patients with cerebral infarction in our hospital treatment were recorded age, smoking, drinking, hypertension, diabetes, etc. patients with the following history were excluded: malignant tumor, seriously abnormal liver and kidney function, severely abnormal cardiac function, massive proteinuria, oral corticosteroids, acute inflammation. Exclusion criteria:patients with cerebral infarction who were after thrombolytic therapy, patients with cerebral infarction and atrial fibrillation, patients with cerebral infarction who were non artery atherosclerosis (such as vasculitis or arteriovenous malformation). By routine biochemical test, blood fat series(TG, TC,HDL-C,LDL-C) and blood sugar series(FBG、2h-pG、HbA1C), blood sugar in96patients was normal, and49patients were impaired glucose tolerance.patients with the history of diabetes mellitus was76cases; patients were performed cervical vascular ultrasound to determine the presence of plaque or not in cervical artery. To record the location of plaque and measure the rate of lumen stenosis.Statistical methods SpSS17.0statistical software was used for processing data. The data was analyzed using single factor analysis of variance for numerical variable, chi-square test for ratio between different groups. Binary logistic regression analysis was used to test the association between abnormal IMT and the factor of producing plaque.Results:1.221patients with cerebral infarction were hospitalized in our hospital form September2011to September2012,of which124cases were large artery atherosclerosis, and it account for56.6%of all patients with cerebral infarction. Among patients with acute cerebral infarction, there were49cases with impaired glucose tolerance and76cases with a clear history of diabetes mellitus and the ratio of the two was3:4;2.analysis of risk factors between groups Comparison of general condition, blood fat, blood sugar and biochemical indicators between normal glucose metabolism (NGT) group, impaired glucose tolerance(IGT) group, diabetes mellitus (DM) group in patient with cerebral infarction. The factors such as age, sex, smoking, systolic blood pressure, diastolic blood pressure, cholesterol and coronary heart disease between NGT group, IGT group, DM group did not have statistical differences (P>0.05). Comparing with NGT group, TG and LDL-C of IGT group and DM group had statistical differences (P<0.05) while they did not have statistical differences between IGT group and DM group (P>0.05).Comparison of plaque between groups The frequency of carotid plaque in DM group was higher than that in NGT group and IGT group. Comparing with NGT group, carotid MT in IGT group and DM group was bigger and the difference was statistical significant. Carotid MT in IGT group was bigger but the difference was not statistical significant.3.Logistic regression analysis showed that MT,2h-PG, HbA1C and FBG had correlativity in IGT group.Conclusions:There were some patients with cerebral infarction of impaired glucose tolerance in patients with cerebral infarction of atherosclerosis.Carotid atherosclerosis was significant in patients with cerebral infarction of impaired glucose tolerance, and IGT was a possible risk factor of leading to atherosclerosis. So we should perform routine OGTT test for patients which had not been diagnosed as DM before to find patients with IGT as soon as possible, and to give them life coaching and drug intervention, to weaken the factors of leading to atherosclerosis, to Slow down the process of plaque’s labilization and these can reduce Incidence of patients with cerebral infarction of atherosclerosis and had important clinic significance for prophylaxis and treatment of cerebral infarction.