Influence of Carotid Intima-Media Thickness Levels at Bifurcation on Short-Term Functional Outcomes Among Non-Cardiogenic Ischemic Stroke Patients with and without Type 2 Diabetes Mellitus

Figures & data

Figure 1 (A) Sagittal scan of carotid ultrasonogram. (B) Longitudinal scan of carotid ultrasonogram. Measurement of IMT (*) at posterior wall of carotid artery bifurcation is shown.

Table 1 Characteristics of All Study Groups Presented Separately in Groups with Poor and Favorable Outcomes

Variables	All N = 314	Favorable Outcomes (mRS≤ 2, n=202)	Poor Outcomes (mRS≥3, n=112)	P-value
Age (y)	67.98±11.71	66.36±11.65	70.91±11.30	0.001
Sex, male	214(68.23%)	139(68.81%)	75(67.01%)	0.736
BMI (Kg/m^2)	24.72±3.67	24.73±3.61	24.69 ±3.89	0.945
Alcohol history	88(28.00%)	59(29.22%)	29(25.91%)	0.531
Smoking history	144(45.93%)	97(48.03%)	47(42.04%)	0.302
Hypertension history	257(81.82%)	162(80.21%)	95(84.82%)	0.309
T2DM history	122(38.92%)	76(37.64%)	46(41.11%)	0.548
Stroke or TIA history	65(20.74%)	36(17.83%)	29(25.93%)	0.091
SBP (mmHg)	148.42±20.42	142.91±19.75	152.99±20.90	0.003
DBP (mmHg)	81.12±12.33	81.08±11.78	81.18±13.31	0.945
Total cholesterol (mmol/l)	4.70±1.29	4.73±1.33	4.63±1.22	0.521
Triglyceride (mmol/l)	1.61±1.50	1.71±1.68	1.42±1.08	0.101
LDL-C (mmol/l)	2.94±0.94	2.92±0.95	2.97±0.92	0.648
HDL-C (mmol/l)	1.09±0.28	1.09±0.30	1.09±0.28	0.899
Haemoglobin (g/l)	134.49±18.61	138.02±16.54	128.14±20.44	<0.001
Uric acid (µmol/l)	322.44±95.45	325.80±91.93	316.35±101.69	0.409
Fasting glucose (mmol/l)	6.68±2.66	6.37±2.45	7.22±2.93	0.007
HbA1c	6.71±1.69	6.61±1.56	6.87±1.89	0.239
Homocysteine (μmol/L)	16.53±12.02	16.05±11.60	17.39±12.74	0.358
NIHSS score	3.00(2.00–6.00)	2.00(1.00–4.00)	6.00(4.00–9.75)	<0.001
IMTbif (mm)	1.42(1.10–1.80)	1.31(1.00–1.60)	1.52(1.00–2.00)	0.001

Abbreviations: BMI, body mass index; T2DM, type 2 diabetes mellitus; TIA, transient ischemic attack; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycosylated haemoglobin; NIHSS, National Institute of Health stroke scale; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; IMTbif, the intima-media thickness at carotid bifurcation.

Table 2 Characteristics of Study Groups Presented Separately in Patients with DM (-) and T2DM (+)

Variables	DM (-) (n=192)	DM (+) (n=122)	P-value
Age(y)	68.09±12.26	67.81±10.84	0.836
Sex, male	129(67.20%)	85(69.70%)	0.645
BMI (Kg/m^2)	24.54±3.49	24.99 ±3.94	0.361
Alcohol history	56(29.21%)	32(26.20%)	0.572
Smoking history	84(43.82%)	60(49.23%)	0.347
Hypertension history	147(76.62%)	110(90.24%)	0.002
Stroke or TIA history	35(18.21%)	30(24.62%)	0.175
SBP (mmHg)	146.31±19.92	151.72±20.84	0.022
DBP (mmHg)	81.57±13.25	80.40±10.74	0.414
Total cholesterol (mmol/l)	4.65±1.21	4.76±1.42	0.493
Triglyceride (mmol/l)	1.30±0.66	2.08±2.16	<0.001
LDL-C (mmol/l)	2.91±0.92	2.99±0.97	0.517
HDL-C (mmol/l)	1.12±0.27	1.05±0.27	0.029
Haemoglobin (g/l)	134.44±17.63	134.59±20.17	0.946
Uric acid (µmol/l)	326.71±95.22	315.71±95.84	0.328
Fasting glucose (mmol/l)	5.7±1.71	8.21±3.13	<0.001
HbA1c	5.8±1.01	7.84±1.68	<0.001
Homocysteine (μmol/L)	17.52±12.69	15.01±10.78	0.079
NIHSS score	3.00(1.00–6.00)	3.50(2.00–5.00)	0.557
mRS score	2.00(1.00–4.00)	2.00(1.00–3.00)	0.300
IMTbif (mm)	1.40(1.10–1.80)	1.40(1.10–1.72)	0.998

Abbreviations: T2DM, type 2 diabetes mellitus; BMI, body mass index; TIA, transient ischemic attack; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycosylated haemoglobin; NIHSS, National Institute of Health stroke scale; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; IMTbif, the intima-media thickness at carotid bifurcation; mRS, modified Rankin Scale.

Table 3 Linear Regression Analysis of Relationships Between Short-Term Functional Outcomes and Variables in Non-Cardiogenic Stroke Patients with T2DM (+)

Variables	Univariate			Multivariate
	Standardized β (95% CI for β)	t-value	P-value	Standardized β (95% CI for β)	t-value	P-value
Age	0.16(−0.00–0.04)	1.85	0.067	-	-	-
Sex	0.04(−0.45–0.72)	0.44	0.658	-	-	-
BMI	0.10(−0.03–0.11)	0.97	0.336	-	-	-
Alcohol history	−0.00(−0.64–0.59)	−0.08	0.940	-	-	-
Smoking history	−0.06(−0.74–0.33)	−0.75	0.453	-	-	-
Hypertension history	−0.01(−0.96–0.86)	−0.11	0.914	-	-	–
Stroke or TIA history	0.17(−0.01–1.23)	1.95	0.053	-	-	-
SBP	0.21(0.00–0.03)	2.30	0.023	0.083(−0.01–0.02)	1.06	0.291
DBP	−0.03(−0.03–0.02)	−0.33	0.742	-	-	-
Total cholesterol	−0.09(−0.29–0.09)	−1.01	0.315	-	-	-
Triglyceride	−0.15(−0.23–0.02)	−1.63	0.105	-	-	-
LDL-C	−0.01(−0.31–0.27)	−0.13	0.896	-	-	-
HDL-C	0.07(−0.65–1.37)	0.70	0.483	-	-	-
Haemoglobin	−0.29(−0.04- −0.01)	−3.22	0.002	−0.16(−0.02–0.00)	−1.94	0.055
Uric acid	0.06(−0.00–0.01)	0.64	0.524	-	-	-
Fasting glucose	0.05(−0.07–0.11)	0.50	0.615	-	-	-
HbA1c	−0.07(−0.23–0.11)	−0.71	0.479	-	-	-
Homocysteine	0.23(0.01–0.06)	2.51	0.014	0.08(−0.01–0.03)	0.96	0.342
NIHSS	0.54(0.16–0.28)	7.02	<0.001	0.45(0.11–0.24)	5.46	<0.001
IMTbif	0.33(0.47–1.48)	3.82	0.001	0.24(0.26–1.15)	3.13	0.002

Abbreviations: T2DM, type 2 diabetes mellitus; BMI, body mass index; TIA, transient ischemic attack; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycosylated haemoglobin; NIHSS, National Institute of Health stroke scale; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; IMTbif, the intima-media thickness at carotid bifurcation; mRS, modified Rankin Scale; CI, confidence interval.

Table 4 Linear Regression Analysis of Relationships Between Short-Term Functional Outcomes and Variables in Non-Cardiogenic Stroke Patients with DM (-)

Variables	Univariate			Multivariate
	Standardized β (95% CI for β)	t-value	P-value	Standardized β (95% CI for β)	t-value	P-value
Age	0.21(0.01–0.05)	3.02	0.003	−0.04(−0.02–0.01)	−0.68	0.496
Sex	0.06(−0.30–0.70)	0.78	0.437	-	-	-
BMI	−0.10(−0.11–0.02)	−1.21	0.228	-	-	-
Alcohol history	−0.05(−0.70–0.35)	−0.66	0.508	-	-	-
Smoking history	−0.10(−0.82–0.13)	−1.44	0.151	-	-	-
Hypertension history	0.10(−0.18–0.93)	1.33	0.184	-	-	-
Stroke or TIA history	0.06(−0.37–0.86)	0.78	0.439	-	-	-
SBP	0.19(0.00–0.03)	2.61	0.010	0.10(−0.00–0.02)	1.85	0.065
DBP	0.02(−0.02–0.02)	0.33	0.739	-	-	-
Total cholesterol	−0.04(−0.26–0.14)	−0.58	0.560	-	-	-
Triglyceride	−0.14(−0.72–0.00)	−1.97	0.051	-	-	-
LDL-C	0.04(−0.19–0.33)	0.52	0.601	-	-	-
HDL-C	−0.00(−0.89–0.88)	−0.01	0.993	-	-	-
Haemoglobin	−0.26(−0.04- −0.01)	−3.54	0.001	−0.23(−0.03- −0.01)	−3.70	<0.001
Uric acid	−0.04(−0.01–0.00)	−0.49	0.628	-	-	-
Fasting glucose	0.25(0.11–0.38)	3.53	0.001	0.22(0.10–0.32)	3.88	<0.001
HbA1c	0.01(−0.26–0.29)	0.11	0.910	-	-	-
Homocysteine	0.07(−0.01–0.03)	0.88	0.379	-	-	-
NIHSS	0.65(0.17–0.24)	11.71	<0.001	0.58(0.15–0.22)	9.59	<0.001
IMTbif	0.21(0.21–1.03)	2.99	0.003	−0.04(−0.45–0.24)	−0.62	0.536

Abbreviations: T2DM, type 2 diabetes mellitus; BMI, body mass index; TIA, transient ischemic attack; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycosylated haemoglobin; NIHSS, National Institute of Health stroke scale; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; IMTbif, the intima-media thickness at carotid bifurcation; mRS, modified Rankin Scale; CI, confidence interval.

Figure 2 Functional outcomes at 3 months stratified for IMT levels at carotid bifurcation.