Liu Ji, Hou Dongzhe, Gao Yuan, Wu Jialing
Department of Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin, China.
Front Neurol. 2018 Feb 26;9:93. doi: 10.3389/fneur.2018.00093. eCollection 2018.
The association between 2-h postprandial blood glucose level (2hPBG) and functional outcomes in patients with small-artery occlusion (SAO) is poorly understood. We aimed to explore the relationship between 2hPBG levels and functional outcomes in SAO patients with diabetes.
We retrospectively analyzed 174 diabetic patients diagnosed with SAO, and 2hPBG values were classified into four groups according to quartiles (<8.90, 8.90 to <12.16, 12.16 to <15.14, and ≥15.14 mmol/L), or according to clinical glycemic recommendations for adults with diabetes (<10 and ≥10 mmol/L, respectively). The relationship between 2hPBG levels and modified Rankin Scale (mRS) scores was assessed using univariate and multivariate analyses.
Among all patients with SAO, there were 139 patients with favorable outcomes and 35 patients with poor outcomes. National Institutes of Health Stroke Scale scores were significantly different according to mRS scores ( < 0.001) in both the univariate and multivariate analyses. The binary logistic regression analyses showed that compared with the lowest quartile (<8.90 mmol/L), elevated 2hPBG levels (8.90 to <12.16, 12.16 to <15.14, and ≥15.14 mmol/L) were not associated with mRS scores after adjusting for multiple confounding factors. Compared with patients with 2hPBG levels <10 mmol/L, those with 2hPBG levels ≥10 mmol/L did not have a significant risk of poor outcome after adjusting for confounders. Meanwhile, the negative results appeared in the ordinal logistic regression of 2hPBG levels and 3-month functional outcomes.
Elevated 2hPBG levels were not associated with unfavorable functional outcomes 3 months after stroke onset in SAO patients with diabetes.
餐后2小时血糖水平(2hPBG)与小动脉闭塞(SAO)患者的功能预后之间的关联尚不清楚。我们旨在探讨糖尿病SAO患者的2hPBG水平与功能预后之间的关系。
我们回顾性分析了174例诊断为SAO的糖尿病患者,根据四分位数(<8.90、8.90至<12.16、12.16至<15.14以及≥15.14 mmol/L)或根据成人糖尿病患者的临床血糖推荐值(分别为<10和≥10 mmol/L)将2hPBG值分为四组。使用单因素和多因素分析评估2hPBG水平与改良Rankin量表(mRS)评分之间的关系。
在所有SAO患者中,139例预后良好,35例预后不良。在单因素和多因素分析中,根据mRS评分,美国国立卫生研究院卒中量表评分均有显著差异(<0.001)。二元逻辑回归分析显示,与最低四分位数(<8.90 mmol/L)相比,在调整多个混杂因素后,升高的2hPBG水平(8.90至<12.16、12.16至<15.14以及≥15.14 mmol/L)与mRS评分无关。与2hPBG水平<10 mmol/L的患者相比,在调整混杂因素后,2hPBG水平≥10 mmol/L的患者预后不良的风险并无显著增加。同时,2hPBG水平与3个月功能预后的有序逻辑回归也得出了阴性结果。
糖尿病SAO患者卒中发作3个月后,升高的2hPBG水平与不良功能预后无关。