Usefulness of the Glucose Concentration-to-HbA1c Ratio in Predicting Hemorrhagic Transformation and Prognosis of the Patients with Acute Ischemic Stroke
第一作者:Jiejie Li,Kehua Quan
通讯作者:Yongjun Wang
2020-09-24
Early studies have found that hyperglycemia is associated with hemorrhagic transformation (HT) in the patients with acute ischemic stroke, regardless of treatment of thrombolysis. Then some researches evaluating the kinetics of glucose after admission showed that only persistent hyperglycemia but not that on admission was related with HT and poor functional outcome. However, most of previous studies have mainly concentrated on the glucose level after stroke onset, without consideration of the background glucose level. Recent studies demonstrated that relative hyperglycemia, defined as glucose-to-glycated hemoglobin (HbA1c) ratio might be a better predictor for outcomes of acute illness than absolute hyperglycemia. We therefore sought to investigate the role of glucose-to-HbA1c ratio in predicting HT and prognosis of the patients with acute ischemic stroke.
The glucose-to-HbA1c ratio was calculated by fasting plasma glucose divided by HbA1c. The association between quartiles of glucose-to-HbA1c ratio and the outcomes were analyzed by using logistic regression models. Further subgroup analyses of nondiabetic patients and patients with diabetes were performed separately. And the interaction of the glucose-to-HbA1c ratio with treatment of thrombolysis on the outcomes were also evaluated.
Stress hyperglycemia, measured by glucose/HbA1c ratio, was associated with increased risk of severe neurological deficit and mortality within 1-year in the acute ischemic stroke people.