Hyperglycemia, duration of diabetes, and intracranial atherosclerotic stenosis by magnetic resonance angiography: The ARIC-NCS study

Akira Fujiyoshi, M. Fareed K. Suri, Alvaro Alonso, Elizabeth Selvin, Haitao Chu, Eliseo Guallar, Ye Qiao, Yiyi Zhang, Bruce A. Wasserman, Aaron R. Folsom

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AIMS: The association of hyperglycemia and duration of diabetes with intracranial atherosclerotic stenosis (ICAS) in the general population is not well documented. We examined whether elevated glucose and longer diabetes duration is independently associated with ICAS in a community-based sample.

METHODS: We cross-sectionally analyzed 1644 participants (age 67-90 years) of the Atherosclerosis Risk in Communities Study who underwent cerebrovascular magnetic resonance angiography in 2011-13. We applied multivariable ordinal logistic regression to evaluate the association of ICAS category ("no stenosis", "stenosis <50%", or "stenosis ≥50%") with glucose or diabetes duration (<10, 10 to 20, and ≥20 years). We also obtained the corresponding odds ratios applying inverse-probability weighting to account for potential selection bias due to attrition.

RESULTS: Compared to non-diabetic participants in the lowest glucose quartile, the weighted odds ratios (95% confidence interval) of higher ICAS category were 1.88 (1.18, 3.00) and 2.01 (1.08, 3.72) for non-diabetic and diabetic participants in the corresponding highest glucose quartile, respectively. We observed significant positive trends of ICAS across diabetes duration categories in unweighted, but not in weighted, analyses.

CONCLUSIONS: Hyperglycemia and longer duration of diabetes were independently associated with ICAS, suggesting the importance of maintaining glycemic control to prevent stroke.

Original languageEnglish (US)
Article number107605
JournalJournal of Diabetes and Its Complications
Issue number9
StatePublished - Sep 2020

Bibliographical note

Funding Information:
This research was supported by National Institutes of Health / National Institute of Diabetes and Digestive and Kidney Diseases grants R01 DK089174 and K24 DK106414 to Dr. Selvin.

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute , National Institutes of Health , Department of Health and Human Services , under Contract nos. ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700004I , HHSN268201700005I ). Neurocognitive data is collected by U01 HL096812, HL096814, HL096899, HL096902, HL096917 with previous brain MRI examinations funded by R01-HL70825. The authors thank the staff and participants of the ARIC study for their important contributions.

Funding Information:
Supported by National Heart, Lung, and Blood Institute (NHLBI) grants under award number R01HL105626 and R01HL105930 . Dr. Fujiyoshi was supported by Fulbright Program ( Fulbright Japan , RS2014-2015 ).

Publisher Copyright:
© 2020 Elsevier Inc.


  • Diabetes
  • Glucose
  • Glycated hemoglobin
  • HbA1c
  • Intracranial atherosclerotic stenosis
  • Risk factor

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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