Marto João Pedro, Saraiva Marlene, Ladeira Filipa, Sá Francisca, Calado Sofia, Viana-Baptista Miguel
Department of Neurology, Hospital Egas Moniz, Lisbon, Portugal.
Department of Neurology, Hospital Egas Moniz, Lisbon, Portugal.
J Stroke Cerebrovasc Dis. 2018 Feb;27(2):352-356. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.005. Epub 2017 Sep 28.
Prediabetes has been associated with unfavorable short-term outcome in patients with ischemic stroke (IS). However, its effect in the subset of young adult patients has not been fully assessed. Our aim was to study the association between prediabetes and 3-month outcome in young adult patients with IS.
This is a retrospective analysis of consecutive patients aged 18-55 years with a clinical diagnosis of acute IS between January 2010 and December 2016. According to their glucose profile, patients were divided in 3 groups: normal glucose metabolism, prediabetes, and diabetes. The outcome at 3 months was assessed by the modified Rankin Scale (mRS) and dichotomized as good (mRS score ≤2) and poor (mRS score >2) outcomes.
A total of 247 patients were included, the median age was 49 years (interquartile range 42-53), and 144 (58.3%) were men. Prediabetes was diagnosed in 79 patients (32.0%) and diabetes was diagnosed in 45 patients (18.2%). Prediabetic (adjusted odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.1, P = .031) and diabetic (adjusted OR 2.8, 95% CI 1.3-6.1, P = .020) patients had a worse prognosis at 3 months. A statistical significant shift in the distribution of the mRS score at 3 months was found in prediabetic (adjusted OR 2.5, 95% CI .3-1.5, P = .002) and diabetic (adjusted OR 3.74, 95% CI .5-2.2, P = .002) patients.
In young adults with IS, prediabetes and diabetes increase the risk of unfavorable outcome at 3 months.
糖尿病前期与缺血性卒中(IS)患者的不良短期预后相关。然而,其在年轻成年患者亚组中的影响尚未得到充分评估。我们的目的是研究糖尿病前期与年轻成年IS患者3个月预后之间的关联。
这是一项对2010年1月至2016年12月期间临床诊断为急性IS的18 - 55岁连续患者的回顾性分析。根据血糖情况,患者被分为3组:正常糖代谢、糖尿病前期和糖尿病。3个月时的预后通过改良Rankin量表(mRS)评估,并分为良好(mRS评分≤2)和不良(mRS评分>2)预后。
共纳入247例患者,中位年龄为49岁(四分位间距42 - 53),144例(58.3%)为男性。79例(32.0%)患者被诊断为糖尿病前期,45例(18.2%)患者被诊断为糖尿病。糖尿病前期(调整后的优势比[OR] 2.4,95%置信区间[CI] 1.1 - 5.1,P = 0.031)和糖尿病(调整后的OR 2.8,95% CI 1.3 - 6.1,P = 0.020)患者在3个月时预后较差。在糖尿病前期(调整后的OR 2.5,95% CI 0.3 - 1.5,P = 0.002)和糖尿病(调整后的OR 3.74,95% CI 0.5 - 2.2,P = 0.002)患者中发现3个月时mRS评分分布有统计学显著变化。
在年轻成年IS患者中,糖尿病前期和糖尿病会增加3个月时出现不良预后的风险。