Journal List > J Korean Diabetes Assoc > v.30(5) > 1062396

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Park, Kim, Kim, Nam, Noh, Ahn, Lee, Cha, Lim, Kim, and Lee: Relation between Cerebral Arterial Pulsatility and Insulin Resistance in Type 2 Diabetic Patients
Original Article
The Journal of Korean Diabetes Association

The Journal of Korean Diabetes Association 2006; 30(5): 347-354.

Published online: 30 September 2006

DOI: https://doi.org/10.4093/jkda.2006.30.5.347

Relation between Cerebral Arterial Pulsatility and Insulin Resistance in Type 2 Diabetic Patients

Jong Suk Park, Chul Sik Kim, Hai Jin Kim, Ji Sun Nam, Tae Woong Noh, Chul Woo Ahn, Kyung Yul Lee1, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee

Department of Internal Medicine, Yonsei University College of Medicine, Korea.

1Department of Neurology, Yonsei University College of Medicine, Korea.

Received 22 May 2006       Accepted 1 September 2006

Copyright © 2006 Korean Diabetes Association

Abstract

Background

Diabetic patients have a 3-fold risk for cerebrovascular disease compared with nondiabetic controls. The aim of the present study was to investigate the association of insulin resistance with pulsatility index (PI) of cerebral arteries in type 2 diabetic patients.

Methods

We compared a group of 90 patients with stroke free, type 2 diabetes and an age- and sex-matched control group of 45 healthy subjects without diabetes. Diabetic patients were divided into 3 groups according to the ISI (insulin sensitivity index). We evaluated PI of the middle cerebral artery (MCA) by transcranial Doppler ultrasonography (TCD) and insulin resistance determined by short insulin tolerance test.

Results

The PI was significantly higher in diabetic patients than that in healthy controls (P < 0.05), and also higher in patients with insulin resistance than that in insulin sensitive diabetic patients (P < 0.05). The PI of the MCA was significantly correlated with age (r= 0.465, P < 0.01), duration of diabetes (r = 0.264, P = 0.025), hypertension (r = 0.285, P = 0.015) and inversely correlated with insulin resistance (r = -0.359, P = 0.030). Multiple regression analysis was performed with PI as a dependent variable and insulin resistance as an independent variable along with known clinical risk factors. Age (β = 0.393, P < 0.01) and duration of diabetes (β = 0.274, P = 0.043) exhibited a significant independent contribution to PI.

Conclusions

PI might be useful markers of the detection of diabetic cerebrovascular changes and insulin resistance, measured with short insulin tolerance test, showed correlations with PI, but age and duration of diabetes contributed independently to the variability in the PI.

Keywords: Insulin resistance, Pulsatility index, Type 2 diabetes

Figures and Tables

Table 1
Clinical Characteristics of Subjects
jkda-30-347-i001

Values are mean ± SD.

BMI, body mass index; FBG, fasting blood glucose; TG, triglyceride; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein cholesterol; SBP, systolic blood pressure; DBP, diastolic blood pressure; MCA, middle cerebral artery; ICA, internal carotid artery; BA, basilar artery; PI, pulsatility index.

*P < 0.05 vs. controls.

†P < 0.05 vs. insulin sensitive group.

Table 2
Mean MCA PI according to Diabetic Microvascular Complications
jkda-30-347-i002

Values are mean ± SD.

MCA, middle cerebral artery; PI, pulsatility index.

Table 3
Correlation Coefficients Determined by Simple Correlation between Mean MCA PI and Other Clinical Factors Possibly Affecting PI in Type 2 Diabetic Subjects.
jkda-30-347-i003

BMI, body mass index; FBG, fasting blood glucose; TG, triglyceride; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein cholesterol; MCA, middle cerebral artery; ICA, internal carotid artery; BA, basilar artery PI, pulsatility index.

Table 4
Multiple Regression Analysis of Clinical Factors Possibly Affecting Mean MCA PI in Type 2 Diabetic Subjects
jkda-30-347-i004

R2 = 0.416

MCA, middle cerebral artery; PI, pulsatility index.

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