Neurology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
Neurology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
BMJ Open. 2021 Mar 26;11(3):e044771. doi: 10.1136/bmjopen-2020-044771.
Insulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.
The authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by ².
No human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.
CRD42020173608.
胰岛素抵抗是动脉粥样硬化、冠心病和缺血性卒中的独立危险因素。目前，胰岛素抵抗通常不包括在卒中后风险分层中。本系统评价和荟萃分析旨在确定现有的科学知识是否支持在无糖尿病的卒中患者中，胰岛素抵抗与卒中后结局之间存在关联。
作者将在 Medline、Embase、Web of Science 和 Cochrane Central 中进行文献检索。本综述将包括评估升高的胰岛素稳态模型评估的胰岛素抵抗（HOMA-IR）与卒中后结局（功能结局和复发性卒中）之间关联的研究。将使用系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）报告指南。主要结局将是卒中后功能结局（改良 Rankin 量表），次要结局将是复发性缺血性卒中。将在每个纳入本系统评价的文章中定义的最高和最低 HOMA-IR 范围之间比较结局。将定性评估偏倚风险。如果研究之间存在足够的同质性，则将进行荟萃分析。通过 ² 评估结局的异质性。
未使用或不会使用人类或动物受试者或样本。研究结果将发表在同行评议的期刊上，并将在当地和国际神经病学会议上传播。
PROSPERO 注册号：CRD42020173608。
