Relationship between blood glucose control and Clopidogrel resistance in patients with acute ischemic cerebrovascular disease with type 2 diabetes mellitus
10.3969/j.issn.1006-6187.2025.11.003
- VernacularTitle:2型糖尿病患者伴急性缺血性脑血管病血糖控制水平与氯吡格雷抵抗相关性的研究
- Author:
Xin MENG
1
;
Dongmei WANG
1
;
Qing LIU
1
Author Information
1. 100007 北京市第六医院神经内科
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
Acute ischemic cerebrovascular disease;
Clopidogrel resistance;
Blood glucose control
- From:
Chinese Journal of Diabetes
2025;33(11):811-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between blood glucose(BG)control levels and Clopidogrel resistance(CR)in patients with type 2 diabetes mellitus(T2DM)complicated with acute ischemic cerebrovascular disease(CIS).Methods A total of 92 patients with T2DM complicated with CIS admitted to our hospital from January 2020 to December 2022 were selected as the research subjects and were divided into the simple T2DM+CIS group(n=32)and the CR group(n=60)based on whether CR occurred after the use of Clopidogrel.Pearson correlation analysis was used to explore the correlation between BG control levels and platelet activation indicators.Logistic regression analysis was conducted to investigate the relationship between hemoglobin A1c(HbA1c)levels and the occurrence of CR.Restricted cubic spline analysis was performed to examine the dose-response relationship between HbA1c fluctuations and the occurrence of CR in patients with T2DM complicated with CIS.Results The CR group had higher values for age,smoking,hyperlipidemia,cerebrovascular disease,peripheral arteriosclerosis,platelet activity units,2-hour postprandial blood glucose(2 hPG),HbA1c,platelet aggregation rate(PagT),platelet count(PLT),platelet volume distribution width(PDW),and platelet hematocrit(PCT)compared to the T2DM+CIS group(P<0.05).The platelet inhibition rate,fasting insulin(FIns),and platelet aggregation rate(PadT)were lower in the CR group than in the T2DM+CIS group(P<0.05).Pearson correlation analysis showed that FIns was positively correlated with PadT(P<0.05),negatively correlated with PagT,PLT,PDW and PCT(P<0.05);2 hPG and HbA1c was negatively correlated with PadT(P<0.05),positively correlated with PagT,PLT,PDW and PCT(P<0.05).Logistic regression analysis revealed that after adjusting for confounding factors,in the total population and gender subgroups,compared with the Q1 group,the CR risk in the Q2 to Q4 groups gradually increased(Pfor trend<0.001).The restricted cubic spline plot showed that in the total population and among men and women,the association strength between HbA1c levels and the risk of CR was non-linear dose-response relationship(P=0.005,0.003,0.002).When HbA1c was higher than the cutoff value,the risk of CR increased as the HbA1c level increased.Conclusions The fluctuation of HbA1c is independently associated with the risk of CR.The poorer the BG control,the higher the risk of CR.
