Diabetes mellitus is a more important determinant for intracranial atherosclerotic stroke than extracranial atherosclerosis or non-atherosclerotic stroke subtype
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The Northern Manhattan Stroke Study, which included a population-based incidence study and a nested case-control study, was designed to assess the prevalence of risk factors for intracranial atherosclerosis (IATH)-related stroke in a multi-ethnic community-based cohort. Vascular risk factors were assessed among controls and compared against the following stroke subtypes: IATH, extracranial atherosclerosis (EATH), and non-atherosclerotic (NATH; cardioembolic, lacunar, or cryptogenic). Conditional logistic-regression revealed that the IATH group had a significantly higher prevalence of diabetes mellitus (DM) and metabolic syndrome when compared to controls (DM: 67% vs 23%, metabolic syndrome: 62% vs 35%, respectively; P<0.05 for both). In multivariate analysis, diabetes mellitus conferred a higher risk for IATH versus NATH stroke subtype, and a much lower one for EATH. The metabolic syndrome conferred a higher risk for IATH stroke compared to EATH and NATH. In conclusion, diabetes mellitus is a more important determinant for IATH-related stroke than for EATH or NATH.
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