Association Of Insulin Resistance Of Internal Carotid Transient Ischemic Attacks And Its Relative Factors

Objective: To study the relationship between insulin resistance(IR) and internal carotid Transient ischemic attacks(TIAs). By detecting blood plasma fibrinogen(FIB), total cholesterol(TC), triglyceride(TG),low density lipoprotein(LDL), high density lipoprotein (HDL), poliprotein-a(ApoA), apoliprotein-b(ApoB), uric acid (UA), tumor necrosis factor-α(TNF-α), fasting plasma glucose (FPG), fasting insulin(FINS),systolic blood pressure(SBP),diastolic blood pressure(DBP),carotid atherosclerosis(CAS),body mass index(BMI), so as to determine the relationship between IR of internal carotid TIAs and its relative factors.Method: 59 cases of internal carotid TIAs, administrated in our hospital from 2005.1 to 2007.2 were diagnosed according to the diagnostic standard of Chinese Medical Association the 4th nationwide cerebrovascular disease academic conferences in October,1995,no past cerebral infarction,cerebral hemorrhage and diabetes mellitus.Among the internal carotid TIAs group 27 for male, 32 for female, from 47 to 86 years old, averaged 65.6±10.3;The control group was consisted of 58 people, among which 25 for male, 33 for female, from 47 to 81 years old, averaged 62.0±9.3.The color Doppler Ultrasound of the carotid artery was conducted on the two groups, detecting the atherosclerosis plaque.At the same time the FIB,TC,TG,LDL,HDL,ApoA,ApoB,UA,TNF-α, FPG, FINS, SBP, DBP were detected, the body mass index(BMI), insulin sensitivity index(ISI), insulin resistance index (HOMA-IR)were calculated. Then the statistics were entered into the computer and analyzed by the SPSS statistic analysis software.Results:1. The TNF-αin the internal carotid TIAs group(17.73±5.20) was much higher than in the control group(13.44±4.80), the difference was significant (P<0.01);The ISI in the internal carotid TIAs group(-3.79±0.81) was muchlower than in the control group(-3.35±0.47), the difference was significant (P<0.01); The HOMA-IR in the internal carotid TIAs group(2.49±1.64) was much higher than in the control group(1.38±0.54), the difference was significant(P<0.01); The FPG in the internal carotid TIAs group(4.89±0.63) was much higher than in the control group(4.58±0.77),the difference was significant(P<0.05);The FINS in the internal carotid TIAs group(11.17±6.43) was much higher than in the control group(6.86±2.56),the difference was significant(P<0.01).The SBP in the internal carotid TIAs group(130.12±7.77) was much higher than in the control group(122.62±12.93),the difference was significant(P<0.01);The FIB in the internal carotid TIAs group((2.98±0.29) was much higher than in the control group (2.71±0.40),the difference was significant (P<0.01); The carotid atherosclerosis occurrence rate in the internal carotid TIAs group was much higher than in the control group, the difference was significant(P<0.01).The percentage of the soft plaques and the mixed plaques in the internal carotid TIAs group was much higher than in the control group, the difference was significant(P<0.05).2. Spearman's Rank correlations showed that the internal carotid TIAs was positively correlated with CAS, FIB, SBP, TNF-α, HOMA-IR, and negatively correlated with ISI; Partial correlations analysis showed that ISI was negatively correlated with TG,ApoB,UA and BMI (P<0.05);The HOMA-IR showed positive correlation with ApoB and BMI(P<0.05).3. The non-condition Logistic regression analysis showed CAS, FIB,SBP, HOMA-IR were dangerous factors of internal carotid TIAs, ApoB,UA,TNF-α,BMI were dangerous factors of HOMA-IR .Conclusions:1. The internal carotid TIAs patients had IR. IR was dangerous factor of internal carotid TIAs. Improving IR was beneficial to prevent internal carotid TIAs.2. The IR was closely correlated with the dangerous factors'aggregation of internal carotid TIAs. The internal carotid TIAs patients had various dangerous factors taking IR as center. Improving IR of internal carotid TIAs could decrease the internal carotid TIAs patients'dangerous factors.3. The internal carotid TIAs'happening was correlated with CAS, CAS was dangerous factor of internal carotid TIAs.The carotid atherosclerotic plaque especially the soft plaque and the mixed plaque played important role in internal carotid TIAs'happening.4. The internal carotid TIAs'happening was correlated with the high FIB. The high FIB was dangerous factor of internal carotid TIAs.5. The TNF-αplayed important role in the internal carotid TIAs'happening, which hinted that inflammation medium had participated in the internal carotid TIAs'happening.