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Homeostasis model assessment of insulin resistance and outcome of ischemic stroke in non-diabetic patients - a prospective observational study

BMC neurology, 2019-07, Vol.19 (1), p.177-177, Article 177 [Peer Reviewed Journal]

COPYRIGHT 2019 BioMed Central Ltd. ;The Author(s). 2019 ;ISSN: 1471-2377 ;EISSN: 1471-2377 ;DOI: 10.1186/s12883-019-1406-3 ;PMID: 31345181

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Title:
Homeostasis model assessment of insulin resistance and outcome of ischemic stroke in non-diabetic patients - a prospective observational study
Author: Åberg, Daniel ; Åberg, N David ; Jood, Katarina ; Holmegaard, Lukas ; Redfors, Petra ; Blomstrand, Christian ; Isgaard, Jörgen ; Jern, Christina ; Svensson, Johan
Subjects: admission hyperglycemia ; association ; blood-glucose ; Cardiovascular diseases ; Clinical Medicine ; Complications and side effects ; Diabetics ; genetic-variation ; Health ; Health aspects ; HOMA-IR ; Homeostasis ; Insulin resistance ; Ischemia ; Ischemic stroke ; Klinisk medicin ; Medical research ; metabolic syndrome ; Modified Rankin scale ; Morbidity ; Neurosciences & Neurology ; of-health stroke ; prognosis ; Risk factors ; sahlgrenska-academy ; scandinavian stroke ; Stroke ; Type 2 diabetes
Is Part Of: BMC neurology, 2019-07, Vol.19 (1), p.177-177, Article 177
Description: Insulin resistance (IR) in relation to diabetes is a risk factor for ischemic stroke (IS), whereas less is known about non-diabetic IR and outcome after IS. In non-diabetic IS (n = 441) and controls (n = 560) from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), IR was investigated in relation to IS severity and functional outcome. IR was evaluated acutely and after 3 months using the Homeostasis model assessment of IR (HOMA-IR). Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS). Functional outcome was evaluated using the modified Rankin Scale (mRS) after 3 months, 2 and 7 years. Associations were evaluated by logistic regression. Higher acute and 3-month HOMA-IR was observed in IS compared to the controls (both p < 0.001) and in severe compared to mild IS (both p < 0.05). High acute HOMA-IR was associated with poor outcome (mRS 3-6) after 3 months and 7 years [crude Odds ratios (ORs), 95% confidence intervals (CIs) 1.50, 1.07-2.11 and 1.59, 1.11-2.30, respectively], but not after 2 years. These associations lost significance after adjustment for all covariates including initial stroke severity. In the largest IS subtype (cryptogenic stroke), acute HOMA-IR was associated with poor outcome after 2 years also after adjustment for age and stroke severity (OR 2.86, 95% CI 1.01-8.12). In non-diabetic IS patients, HOMA-IR was elevated and related to stroke severity, but after adjustment for IS severity, the associations between HOMR-IR and poor outcome lost significance. This could suggest that elevated IR mostly is a part of the acute IS morbidity. However, in the subgroup of cryptogenic stroke, the associations with poor outcome withstood correction for stroke severity.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1471-2377
EISSN: 1471-2377
DOI: 10.1186/s12883-019-1406-3
PMID: 31345181
Source: GFMER Free Medical Journals
PubMed Central
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals
Springer Nature OA Free Journals

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Homeostasis model assessment of insulin resistance and outcome of ischemic stroke in non-diabetic patients - a prospective observational study

COPYRIGHT 2019 BioMed Central Ltd. ;The Author(s). 2019 ;ISSN: 1471-2377 ;EISSN: 1471-2377 ;DOI: 10.1186/s12883-019-1406-3 ;PMID: 31345181

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