Department of Neurology, Huizhou First Hospital, Huizhou, China.
Horm Metab Res. 2022 Jun;54(6):371-379. doi: 10.1055/a-1837-0141. Epub 2022 Jun 13.
Dysglycemia are involved in the development of functional impairment after acute ischemic stroke (AIS). The aim of the study was to evaluate the association between acute glycemic variability and functional outcome in patients with AIS. Cohort studies were obtained by search Medline, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure databases from inception to November, 2021. A random-effect model which incorporates the intra-study heterogeneity was chosen to pool the results. Ten cohort studies including 3038 patients were included, and 1319 (43.4%) had poor functional outcome (modified Rankin Scale >2) up to three months after disease onset. Pooled results showed that higher acute GV was associated with an increased risk of poor functional outcome, as evidenced by GV evaluated by the standard deviation of blood glucose (SDBG, OR: 1.91, 95% CI: 1.38 to 2.65, I2=60%, p<0.001), the coefficient of variation of blood glucose (OR: 2.03, 95% CI: 1.15 to 3.58, I2=17%, p=0.02), the range of glucose (OR: 1.43, 95% CI: 1.11 to 1.83, I2=22%, p=0.005), and the mean amplitude of glycemic excursion (OR: 1.59, 95% CI: 1.10 to 2.31, I2=0%, p=0.01). Subgroup analyses did not support that difference in study design, treatments for AIS, mean age of the patients, duration for GV measuring, or study quality would significantly affect the association between SDBG and functional outcome after AIS. In conclusion, higher acute glycemic variability may predict poor functional outcome within 3 months after AIS.
血糖异常与急性缺血性脑卒中（AIS）后功能障碍的发展有关。本研究旨在评估急性血糖变异性与 AIS 患者功能结局之间的关系。通过检索 Medline、Web of Science、Embase、万方和中国知识基础设施数据库，从建库至 2021 年 11 月获得队列研究。选择包含研究内异质性的随机效应模型来汇总结果。纳入了 10 项队列研究，共 3038 例患者，其中 1319 例（43.4%）在发病后 3 个月时功能预后不良（改良 Rankin 量表>2）。汇总结果表明，较高的急性血糖变异性与不良功能结局风险增加相关，这一点通过血糖标准差（SDBG）评估的血糖变异性（OR：1.91，95%CI：1.38 至 2.65，I2=60%，p<0.001）、血糖变异系数（OR：2.03，95%CI：1.15 至 3.58，I2=17%，p=0.02）、血糖范围（OR：1.43，95%CI：1.11 至 1.83，I2=22%，p=0.005）和血糖波动幅度（OR：1.59，95%CI：1.10 至 2.31，I2=0%，p=0.01）评估的血糖变异性均得到证实。亚组分析不支持研究设计、AIS 治疗、患者平均年龄、血糖变异性测量持续时间或研究质量的差异会显著影响 SDBG 与 AIS 后功能结局之间的关联。总之，较高的急性血糖变异性可能预示着 AIS 后 3 个月内功能结局不良。
