Background and Purpose: Cerebral artery stenosis is known as an important cause of stroke, and elevated fasting glucose level is also considered as a risk factor for stroke. Our aim was to exam whether elevated fasting glucose is associated with cerebral artery stenosis, especially asymptomatic cerebral artery stenosis. Methods: The current study included 5309 participants who were age of 40 years or older, and free of stroke, transient ischemic attack, and coronary artery disease. Cerebral artery stenosis was assessed by Doppler ultrasound. Participants were classified into four subtypes: no cerebral artery stenosis (NCS), intracranial artery stenosis (ICAS), extracranial carotid artery stenosis (ECCS) and combined intracranial artery and extracranial carotid artery stenosis (IECS). Fasting blood glucose concentrations were grouped into: normal fasting glucose (<5.60 mmol/l), impaired fasting glucose 1 (IFG1) (5.60-6.09 mmol/l), IFG2 (6.10-6.99 mmol/l) and diabetes (>= 7.00 mmol/l). A multinomial logistic regression was used to examine the association between fasting glucose and cerebral artery stenosis, after adjusting for potential confounders. Results: Fasting glucose level was significantly higher in ICAS and IECS groups than the other two groups. In the multinomial logistic regression analysis, IFG2 was the risk factor for ICAS (odds ratio (OR) 1.53, 95% confidential interval (CI), 1.12-2.10), and diabetes was a strong predictor for both ICAS (OR 1.75, 95% CI, 1.38-2.22) and IECS (OR 2.14, 95% CI 1.31-3.49). However, fasting glucose level was not significantly associated with ECCS. Conclusions: Our results showed that elevated fasting glucose levels are associated with asymptomatic cerebral artery stenosis, especially ICAS and IECS. (C) 2014 Elsevier Ireland Ltd. All rights reserved.