国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Insulin Resistance Is an Independent Risk Factor for Early Neurological Deterioration in Non-Diabetic Patients With Acute Ischemic Stroke

第一作者：Donghua Mi

通讯作者：Liping Liu

Stroke . Insulin resistance . Early neurological d

基本信息

2020-01-14

已发表文章

发表杂志：Neurological Sciences

发表类型: Full Paper

影响因子(IF): 3.307

PMID: 31938983 Pubmed原文链接 全文下载

主要研究背景及目的

To investigate insulin resistance (IR) prevalence among non-diabetic patients with acute ischemic stroke and the association between IR, insulin sensitivity (IS) and β-cell function and the risk of Early Neurologic Deterioration(END) in non-diabetic patients with ischemic stroke.

方法

This is a retrospective analysis of non-diabetic patients with acute ischemic stroke enrolled in the prospective multicenter ACROSS-China study. The homeostasis model assessment 2 (HOMA2-IR) was evaluated and the patients were divided into HOMA2-IR quartiles (Q1 0-1.24, Q2 1.25-1.95, Q3 1.96-2.96, Q4 ≥ 2.97). END was defined as an increment in total National Institutes of Health Stroke Scale (NIHSS) of ≥ 2 points or ≥ 4 points on day 14 ± 3 after stroke onset. Logistic regression was performed to explore the relationship between HOMA2-IR and END.

结论

This study strongly suggests that IR is probably an independent risk factor for END in non-diabetic patients with acute ischemic stroke

主要结果

Finally, 556 patients were included (63.7 ± 12.9 years, 64.6% male); thirty-three patients developed END. The median HOMA2-IR of all patients was 1.95 (inter-quartile = 1.24-2.96). There were 148, 135, 130, and 143 patients in Q1, Q2, Q3, and Q4, respectively. Compared with Q1, END (NIHSS ≥ 2) risk was increased in Q4: adjusted odds ratio (OR) = 6.051, 95% CI = 1.638-22.354, P = 0.0069. In additon, END (NIHSS ≥ 2) risk was increased in Q4 compared with the Q1-Q3 combined group: adjusted OR = 2.853, 95% CI = 1.308-6.224, P = 0.0084. END (NIHSS ≥ 4) risk was also increased in Q4: adjusted OR = 7.507, 95% CI = 2.357-23.906, P = 0.0006) compared with the Q1-Q3 combined group.