Correlation of diabetes mellitus with risk of intracranial and extracranial atherosclerotic stenosis

Background and aims : The reasons for the significantly higher prevalence of intracranial atherosclerotic stenosis (ICAS) compared to extracranial atherosclerotic stenosis (ECAS) in the Asian population remain unclear. This paper investigated whether diabetes mellitus is correlated with this difference. Methods : A retrospective analysis was conducted on the clinical records of patients who consulted the Neurology Department. Magnetic resonance angiography and color Doppler ultrasound were applied to examine intracranial and extracranial arteries. Subjects were divided into three categories: ICAS group, ECAS group, and the group without intracranial and extracranial atherosclerotic stenosis (Non-AS). Binary logistic regression studies were conducted to examine the relationship between diabetes mellitus, glycosylated hemoglobin (HbA1c) levels, and the likelihood of ICAS and ECAS. Results : Of 1003 subjects, there were 255 patients with ICAS, 149 patients with ECAS and 599 patients without ICAS and ECAS, respectively. Diabetes and HbA1c levels were notably more prevalent in the ICAS group compared to the Non-AS group (P <0.001), yet no significant disparity was found between the ECAS and Non-As groups (P >0.05). Binary logistic regression analysis indicated a strong correlation between diabetes mellitus and HbA1c levels with the risk of ICAS (P <0.001), while no significant association was found with ECAS risk (P >0.05). A significant elevation in ICAS risk was observed with an HbA1c level ≥6.5% (P = 0.001). Conclusion : Diabetes mellitusmay be one of the factors contributing to the differences in the distribution of intracranial and extracranial atherosclerotic stenosis.