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 1.594.86, 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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2013BAI09B03, 2013BAI09B14, 2015BAI12B04, 2015BAI12B02]; Beijing Biobank of Cerebral Vascular Disease [D131100005313003]; Beijing Institute for Brain Disorders [1152130306]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81322019]; Beijing Municipal Science and Technology CommissionBeijing Municipal Science & Technology Commission [D131100002313002, D151100002015001, D151100002015002, D151100002015003, Z15110200390000, Z151100003915117]; Beijing Municipal Commission of Health and Family Planning [2016-1-2041, SML20150502]
第一作者机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China;[2]Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Beijing, Peoples R China;[3]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;[4]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China;[5]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
通讯作者:
通讯机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China;[2]Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Beijing, Peoples R China;[3]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;[4]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China;[5]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;[7]Beijing Municipal Key Lab Clin Epidemiol, Beijing, Peoples R China;[8]6 Tiantanxili, Beijing 100050, Peoples R China;[9]10 Xitoutiao, Beijing 100069, Peoples R China
推荐引用方式(GB/T 7714):
Pan Yuesong,Jing Jing,Chen Weiqi,et al.Post-Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke[J].JOURNAL OF THE AMERICAN HEART ASSOCIATION.2017,6(1):-.doi:10.1161/JAHA.116.004990.
APA:
Pan, Yuesong,Jing, Jing,Chen, Weiqi,Zheng, Huaguang,Jia, Qian...&Wang, Yongjun.(2017).Post-Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke.JOURNAL OF THE AMERICAN HEART ASSOCIATION,6,(1)
MLA:
Pan, Yuesong,et al."Post-Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke".JOURNAL OF THE AMERICAN HEART ASSOCIATION 6..1(2017):-