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Post-glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke
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نویسنده
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pan y. ,jing j. ,chen w. ,zheng h. ,jia q. ,mi d. ,li h. ,zhao x. ,liu l. ,wang c. ,gaisano h.y. ,he y. ,wang y. ,wang y.
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منبع
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journal of the american heart association - 2017 - دوره : 6 - شماره : 1
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چکیده
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Background--insulin resistance is associated with an increased risk of cardiovascular events in the general population. this study aimed to estimate the association between post-glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke. methods and results--data were derived from the across-china (abnormal glucose regulation in patients with acute stroke across china) registry. patients with ischemic stroke without a history of diabetes mellitus were included. two post-glucose load measures of insulin sensitivity,the insulin sensitivity indices isi(composite) and the isi0,120,were calculated. outcomes included stroke recurrence,all-cause death,and poor functional outcome at 12 months. among 1203 patients,63.3% were male with an average age of 62.1 years. at 12 months,168 (14.4%) patients had recurrent stroke,111 (9.2%) had died,and 288 (24.4%) had poor outcome. after adjustment for potential covariates,the first quartile of the isi(composite) was associated with increased 12-month stroke recurrence (adjusted hazard ratio 2.02,95% ci 1.28-3.18,p=0.003),death (adjusted hazard ratio 2.78,95% ci 1.59-4.86,p < 0.001),and poor outcome (adjusted odds ratio 2.67,95% ci 1.69-4.21,p < 0.001) compared with the fourth quartile. similar results were observed for the isi0,120 but with a larger magnitude of association. using a multivariable regression model with restricted cubic spline,we found an l-shaped association between the insulin sensitivity indices and the risk of each end point. conclusions--in this large-scale registry,post-glucose load measures of insulin resistance with the isi(composite) and the isi0,120 were associated with 12-month poor outcomes of nondiabetic patients with ischemic stroke. © 2017 the authors.
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کلیدواژه
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Diabetes mellitus; Insulin resistance; Outcome; Stroke
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آدرس
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department of neurology,beijing tiantan hospital,capital medical university,beijing,china,department of epidemiology and health statistics,school of public health,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of physiology,university of torontoon, Canada, department of epidemiology and health statistics,school of public health,capital medical university,beijing,china,beijing municipal key laboratory of clinical epidemiology,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China, department of neurology,beijing tiantan hospital,capital medical university,beijing,china,china national clinical research center for neurological diseases,beijing,china,center of stroke,beijing institute for brain disorders,beijing,china,beijing key laboratory of translational medicine for cerebrovascular disease,beijing, China
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