Chaturvedi Poonam, Singh Ajai Kumar, Tiwari Vandana, Thacker Anup Kumar
Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Biochemistry, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2020 Feb 28;9(2):1035-1041. doi: 10.4103/jfmpc.jfmpc_884_19. eCollection 2020 Feb.
The recovery after stroke depends on the resolution of brain edema and neuroplasticity. The comorbidities associated with stroke such as type 2 diabetes mellitus (T2DM) may increase the chances of unfavorable outcome and delay the recovery from stroke and needs further investigation.
The study dealt with 208 patients. The neurological status of the patients was assessed by Glasgow Coma Scale and the severity of stroke was assessed by the National Institute of Health Stroke Scale. Patients were divided into two groups: T2DM in group 1 and without T2DM in group 2. We assessed functional improvement by Functional Independence Measure (FIM) Scale, quality of life by Stroke Specific Quality of Life (SSQOL) Scale, and serum levels of brain-derived neurotrophic factor (BDNF) for assessing neuroplasticity.
We observed lower levels of BDNF in diabetic stroke patients. There was significant improvement in FIM scale scores and SSQOL scale scores in non-diabetic stroke patients after 6 months ( < 0.05). The relative risk (RR) of poor functional recovery (FIM) in the diabetic group was 1.34 [95% confidence interval (CI) 1.0-1.8] and the odds ratio (OR) was 1.8 (95% CI 1.03-3.12). Diabetes is an independent risk factor for poor BDNF recovery (serum BDNF < mean value, i.e. 10.07 ± 3.8 ng/mL) (RR 2.40; 95% CI: 1.36-4.21 and OR 1.6; 95% CI: 1.15-2.13] and poor quality of life (RR 1.56; 95% CI: 1.13-2.16 and OR 2.83; 95% CI: 1.14-7.0).
Diabetes is not only a risk factor for stroke occurrence but also delayed recovery after stroke.
中风后的恢复取决于脑水肿的消退和神经可塑性。与中风相关的合并症，如2型糖尿病（T2DM），可能会增加不良预后的几率，并延迟中风后的恢复，需要进一步研究。
该研究涉及208名患者。通过格拉斯哥昏迷量表评估患者的神经状态，通过美国国立卫生研究院卒中量表评估中风的严重程度。患者分为两组：第1组为T2DM患者，第2组为无T2DM患者。我们通过功能独立性测量（FIM）量表评估功能改善情况，通过卒中特异性生活质量（SSQOL）量表评估生活质量，并通过血清脑源性神经营养因子（BDNF）水平评估神经可塑性。
我们观察到糖尿病中风患者的BDNF水平较低。非糖尿病中风患者在6个月后FIM量表评分和SSQOL量表评分有显著改善（<0.05）。糖尿病组功能恢复不良（FIM）的相对风险（RR）为1.34[95%置信区间（CI）1.0 - 1.8]，优势比（OR）为1.8（95%CI 1.03 - 3.12）。糖尿病是BDNF恢复不良（血清BDNF<平均值，即10.07±3.8 ng/mL）的独立危险因素（RR 2.40；95%CI：1.36 - 4.21和OR 1.6；95%CI：1.15 - 2.13）以及生活质量差的独立危险因素（RR 1.56；95%CI：1.13 - 2.16和OR 2.83；95%CI：1.14 - 7.0）。
糖尿病不仅是中风发生的危险因素，也是中风后恢复延迟的危险因素。
