Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 72-80
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.72
Investigating the relationship between intracranial atherosclerotic plaque remodelling and diabetes using high-resolution vessel wall imaging
Yong-Qian Mo, Hai-Yu Luo, Han-Wen Zhang, Yu-Feng Liu, Kan Deng, Xiao-Lei Liu, Biao Huang, Fan Lin
Yong-Qian Mo, Department of Radiology, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Hai-Yu Luo, Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Han-Wen Zhang, Yu-Feng Liu, Biao Huang, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510282, Guangdong Province, China
Han-Wen Zhang, Xiao-Lei Liu, Fan Lin, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518036, Guangdong Province, China
Kan Deng, Research Department, Philips Healthcare, Guangzhou 518000, Guangdong Province, China
Biao Huang, Department of Radiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510000, Guangdong Province, China
Co-corresponding authors: Fan Lin and Biao Huang.
Author contributions: Mo YQ, Luo HY, and Zhang HW performed equally in conducting the data analyses and played pivotal roles in drafting and refining the manuscript; Deng K, Zhang HW, and Liu YF also made substantial contributions to the data analysis and manuscript preparation, enriching the intellectual content of the work; Liu XL helped perform the analysis with constructive discussions. Lin F and Huang B have been designated as co-corresponding authors due to their instrumental roles in conceiving, developing, and supporting the study. Beyond offering critical insights and design perspectives, both authors provided substantial project support, underscoring their commitment to the research's success. Their collaborative leadership ensured the study's robust conceptualization, and their shared responsibilities reflect a deep involvement in securing resources and facilitating the project's progression. Recognized for their equal and significant contributions, Lin F and Huang B's roles as co-corresponding authors highlight not only their intellectual input but also their tangible support, reinforcing the importance of their involvement in every aspect of the study. Luo HY contributed equally to this article as Mo YQ, for which our team expresses gratitude.
Supported by National Natural Science Foundation of China, No. 82071871; Guangdong Basic and Applied Basic Research Foundation, No. 2021A1515220131; Guangdong Medical Science and Technology Research Fund Project, No. 2022111520491834; and Clinical Research Project of Shenzhen Second People's Hospital, No. 20223357022.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Peking University Shenzhen Hospital.
Informed consent statement: This study was retrospective, and the patient information was anonymized. The patients were therefore exempted from signing informed consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) licence, which permits others to distribute, remix, adapt, build upon this work noncommercially, and licence their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See:
Corresponding author: Fan Lin, MD, Doctor, Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, No. 3002 Sungangxi Road, Shenzhen 518036, Guangdong Province, China.
Received: October 11, 2023
Peer-review started: October 11, 2023
First decision: November 2, 2023
Revised: November 14, 2023
Accepted: December 13, 2023
Article in press: December 13, 2023
Published online: January 15, 2024
Research background

Intracranial atherosclerosis, a leading cause of stroke, involves arterial plaque formation.

Research motivation

This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging (HR-VWI).

Research objectives

To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.

Research methods

Exploratory techniques were employed in this investigation, focusing on unraveling the intricate relationship between intracranial atherosclerosis and diabetes. A cohort of 94 individuals diagnosed with atherosclerosis in the middle cerebral artery or basilar artery was assembled for scrutiny. Rigorous data collection ensued, supplemented by HR-VWI. Employing sophisticated image postprocessing, the vascular area at the plaque and normal reference vessel were meticulously measured. The remodelling index (RI) served as a pivotal metric, categorizing patients into distinct remodelling groups. Statistical analyses illuminated pronounced associations between positive remodelling (PR) and heightened diabetes prevalence, substantiating the critical role of HR-VWI in delineating vascular nuances.

Research results

The study's findings illuminate compelling insights into the intricate dynamics of intracranial atherosclerosis. Notably, the PR group, identified through the RI, exhibited a significantly higher diabetes prevalence (45.2%) compared to intermediate remodelling and negative remodelling groups. This statistical distinction underscores the intimate connection between diabetes and atherosclerotic plaque characteristics. Additionally, the PR group demonstrated elevated serum cholesterol and triglyceride levels, reinforcing the correlation. Logistic regression analysis identified diabetes mellitus as an independent influencer in plaque-PR, further emphasizing its significance. The conclusive link between diabetic status and increased PR highlights the potential vulnerability and heightened stroke risk associated with intracranial atherosclerotic plaques in diabetic patients.

Research conclusions

In summation, our research underscores the pivotal role of HR-VWI in elucidating the intricate dynamics of intracranial atherosclerosis. The PR observed in diabetic patients accentuates a concerning association, indicative of heightened plaque instability and an augmented risk of stroke. The distinct patterns unveiled through the RI delineate varying degrees of atherosclerotic changes, with the PR group exhibiting a pronounced correlation with diabetes mellitus. These findings not only enhance our understanding of plaque characteristics but also emphasize the critical importance of HR-VWI in identifying at-risk individuals. This study contributes valuable insights that may inform targeted interventions for diabetic patients with intracranial atherosclerosis, potentially mitigating the risk of stroke.

Research perspectives

Our research opens avenues for further exploration and clinical implications. The identified correlation between PR and diabetes in intracranial atherosclerosis prompts future investigations into the underlying mechanisms. Understanding the intricate interplay between diabetes and plaque dynamics can inform tailored preventive strategies. Additionally, this study underscores the significance of HR-VWI as a diagnostic tool, suggesting its potential integration into routine clinical assessments for at-risk populations. Exploring therapeutic interventions that target plaque stability in diabetic patients may emerge as a crucial research direction, aiming to mitigate the heightened stroke risk. Overall, our findings pave the way for multidisciplinary collaborations and advancements in both diagnostic approaches and preventive measures for individuals with intracranial atherosclerosis and diabetes.