National Obesity Centre and Health of Population in Transition Research Group, FMBS, University of Yaounde 1, Yaounde, Cameroon.
J Stroke Cerebrovasc Dis. 2012 Nov;21(8):639-46. doi: 10.1016/j.jstrokecerebrovasdis.2011.02.009. Epub 2011 Jun 17.
To assess the pattern of metabolic profile associated with first stroke episode in a hospital setting in Cameroon.
All patients admitted for first-ever-in-lifetime stroke over a 6-month period were eligible for inclusion in the study. The 84% participation rate yielded 57 of 68 patients between 16 and 85 years of age. Fifty-seven control subjects were selected to match patients included for age range, sex, and known hypertension and diabetes. We measured fasting serum glucose, insulin, and lipids in controls and in patients between days 3 and 7 after admission.
Total cholesterol was comparable in patients and controls (172.6 ± 39.5 v 175.4 ± 49.7 mg/dL; P = .75), as were triglycerides (129.4 ± 56.1 v 122.4 ± 60.7 mg/dL; P = .53). high-density lipoprotein cholesterol (HDL-C) levels were lower in patients than in controls (37.4 ± 20.6 v 50.2 ± 18.0 mg/dL; P = .001), with comparable levels of low-density lipoprotein cholesterol (LDL-C; 109.4 ± 43.0 v 100.7 ± 48.8 mg/dL; P = .32). The LDL-C/HDL-C ratio was higher in patients compared to controls (4.0 ± 3.0 v 2.3 ± 1.7; P = .0001), as was the total cholesterol/HDL-C ratio (5.9 ± 3.5 v 3.9 ± 1.8; P = .0001). Compared to controls, stroke patients had higher fasting insulin levels (5.9 ± 5.4 v 2.3 ± 3.2 IU/mL; P < .001) and higher insulin resistance as measured by the homeostatic model assessment of insulin resistance (1.9 ± 2.2 v 0.7 ± 1.0; P = .001).
Stroke is associated with markers of insulin resistance, low serum levels of HDL, and high total cholesterol/HDL ratio in this African population. Studies with a larger sample size and cohort designs are warranted to explore the causal pathways, persistence of these abnormalities, and population-specific cut points.
评估喀麦隆医院环境中与首次脑卒中发作相关的代谢特征模式。
所有在 6 个月期间因首次终生脑卒中而入院的患者均符合入组条件。84%的参与率得出了 57 名年龄在 16 至 85 岁之间的患者。选择 57 名匹配患者的对照者，以匹配年龄范围、性别以及已知的高血压和糖尿病。我们在入院后第 3 至 7 天测量了对照组和患者的空腹血清葡萄糖、胰岛素和脂质。
患者的总胆固醇与对照组相当（172.6 ± 39.5 v 175.4 ± 49.7 mg/dL；P =.75），甘油三酯也是如此（129.4 ± 56.1 v 122.4 ± 60.7 mg/dL；P =.53）。高密度脂蛋白胆固醇（HDL-C）水平在患者中低于对照组（37.4 ± 20.6 v 50.2 ± 18.0 mg/dL；P =.001），而低密度脂蛋白胆固醇（LDL-C）水平相当（109.4 ± 43.0 v 100.7 ± 48.8 mg/dL；P =.32）。与对照组相比，患者的 LDL-C/HDL-C 比值更高（4.0 ± 3.0 v 2.3 ± 1.7；P =.0001），总胆固醇/HDL-C 比值也是如此（5.9 ± 3.5 v 3.9 ± 1.8；P =.0001）。与对照组相比，脑卒中患者的空腹胰岛素水平更高（5.9 ± 5.4 v 2.3 ± 3.2 IU/mL；P <.001），并且胰岛素抵抗程度更高，根据稳态模型评估的胰岛素抵抗指数（HOMA-IR）来衡量（1.9 ± 2.2 v 0.7 ± 1.0；P =.001）。
在该非洲人群中，脑卒中与胰岛素抵抗标志物、血清低水平 HDL 和高总胆固醇/HDL 比值相关。需要更大样本量和队列设计的研究来探索因果途径、这些异常的持续存在以及特定人群的切点。
