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糖尿病患者和非糖尿病患者缺血性中风后空腹血糖升高及功能转归的观察

Observation of elevated fasting blood glucose and functional outcome after ischemic stroke in patients with and without diabetes.

作者信息

Xue Wen-Yu, Xu Yan-Cheng, Wu Yu-Wen, Yang Miao

机构信息

Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

Oncotarget. 2017 Jul 7;8(40):67980-67989. doi: 10.18632/oncotarget.19074. eCollection 2017 Sep 15.

Abstract

During May 2015 to October 2016, this prospective study enrolled a total of 438 patients with acute ischemic stroke(AIS), meanwhile, records regarding the severity of initial stroke and neurological outcomes at three months, as well as other examination were completed in patients on admission, as well as the measurement and evaluation of fasting blood glucose(FBG) levels. At admission, the median FBG levels in patients with a minor stroke (n=124), [P<0.001]) was significantly lower than that observed in patients with other degrees of stroke. The poor functional outcome distribution across the FBG quartiles ranged from 13.8 % (first quartile) to 59.6% (fourth quartile), with P <0.001. Compared with the reference category (first quartile), patients in the highest quartile had a relative risk of 3.12 (95% confidence interval [CI], 1.88-6.15; P<0.001) while those in the second and third quartiles had relative risks of 1.76 (95% CI, 1.21-3.03; P=0.035) and 2.23 (95% CI, 1.50-3.69; P=0.010), respectively. Furthermore, in the patients without diabetes, FBG level was observed to be increased and indicated an increased risk of disability (odds ratio [OR]: 1.30 (95%CI 1.13-1.61), P=0.002), however, similar result was not detected in patients with prior diabetes (P=0.089). In conclusion, elevated FBG levels after stroke may suggest poor functional outcome at 3-month in patients without a previous history of diabetes.

摘要

在2015年5月至2016年10月期间,这项前瞻性研究共纳入了438例急性缺血性卒中(AIS)患者,同时,记录了患者入院时初始卒中的严重程度、三个月时的神经学转归以及其他检查结果,还完成了空腹血糖(FBG)水平的测定和评估。入院时,轻度卒中患者(n = 124)的FBG水平中位数[P<0.001]显著低于其他程度卒中患者。FBG四分位数间功能转归不良的分布范围为13.8%(第一四分位数)至59.6%(第四四分位数),P<0.001。与参照组(第一四分位数)相比,最高四分位数组患者的相对风险为3.12(95%置信区间[CI],1.88 - 6.15;P<0.001),而第二和第三四分位数组患者的相对风险分别为1.76(95%CI,1.21 - 3.03;P = 0.035)和2.23(95%CI,1.50 - 3.69;P = 0.010)。此外,在无糖尿病患者中,观察到FBG水平升高且提示残疾风险增加(比值比[OR]:1.30(95%CI 1.13 - 1.61),P = 0.002),然而,既往有糖尿病的患者未检测到类似结果(P = 0.089)。总之,卒中后FBG水平升高可能提示无糖尿病史患者在3个月时功能转归不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9a9/5620229/1b7947f7d5f0/oncotarget-08-67980-g001.jpg

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