High levels of HbA 1c were associated with cerebral microbleeds and white matter hyperintensities in lacunar stroke patients

초록

Background and aims:Diabetes mellitus(DM) is one of major risk factors for stroke including small vessel disease. There are several indicators of cerebral smallvessel state, including white matter hyperintensities(WMHs) and cerebral microbleeds(CMBs). The association of indicators between DM and brain microvascularstatus remains limited. We investigated which biomarkers of DM are associated with brain damages in DM patients with lacunar stroke. Materials and methods: From January 2010 to May 2020, patients with DM and acute lacunar infarction were selected from among those admitted to aUniversity Hospital. All participants filled out a diabetes questionnaire and underwent blood tests and brain magnetic resonance imaging on admission.Multivariable logistic regression analysis was used to analyze the association between DM duration, insulin injection history, and HbA1c levels with CMBs orWMHs. Results: Total Of 633 enrolled subjects, 120(19%) had CMBs and higher HbA1c, defined as 7.5% or higher, was independently associated with CMBs. In patientswith concomitant essential hypertension(HT), higher HbA1c levels were associated with WMH and CMB, even after adjusting for age and gender. Duration ofdiabetes or history of insulin injections was not associated with brain markers. Conclusion:In patients with DM who had suffered a lacunar stroke, higher HbA1c levels were associated with CMBs. Additionally, higher HbA1c was associatedwith WMH grades in patients with DM and HT. These findings suggest that controlling diabetes is important for people with brain small vessel disease.