Murugesan Venkatram, Natesan Murugesan, Sulthana Vahidha, Donapaty Pranav R
Nephrology, East Coast Hospitals, Pondicherry, IND.
Biology, Eastlake High School, Sammamish, USA.
Cureus. 2024 Aug 27;16(8):e67976. doi: 10.7759/cureus.67976. eCollection 2024 Aug.
Introduction Stroke is a serious medical condition characterized by the sudden interruption of blood flow to the brain, resulting in the death of brain cells. It is a leading cause of long-term disability and mortality worldwide. Stroke has some associated risk factors, both modifiable and non-modifiable ones. As for non-modifiable risk factors, these are age, gender (men are more vulnerable), and family history of stroke. The controllable or adjustable risk factors include hypertension (high blood pressure), diabetes, smoking, high cholesterol levels, obesity, and insulin resistance. Methods In our study, we collected data from 229 patients which were originally collected for clinical purposes and were retrospectively analyzed. These data contain features such as sex and age, the presence of ischemic heart disease (IHD) or stroke history, and different blood sugar readings. These measurements include fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c%, and insulin levels (fasting and postprandial). Furthermore, cholesterol was also tested, such as total cholesterol, triglycerides (TGL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). Surprisingly, stroke was observed in 24 of the 205 patients. This contrast permits us to be concerned with the chance of the association between stroke and insulin levels. Given the imbalanced nature of our outcome variable (stroke occurrence), the primary analytical method will be logistic regression. Results In this cross-sectional study, we investigated the association between high insulin levels (both fasting and postprandial) and the occurrence of stroke within a dataset of 229 patients. Out of the 229 included cases, 102 individuals were female (44.5%) and 127 individuals were male (55.5%). Twenty-four cases have ischemic heart disease (10.5%). Among the analyzed cases, 24 individuals have a history of stroke. The average age of the sample is approximately 57 years ± 14.87. There was no significant difference between the males and females in most of the descriptive statistics. However, females experienced significantly higher levels of postprandial glucose level and significantly lower levels of postprandial insulin. According to our predictive model, we found that an increase in fasting insulin levels was linked to a lower risk of stroke occurrence. On the other hand, increasing insulin postprandial levels and age were associated with an increased risk of stroke. Conclusion Our study identified age, fasting insulin, and postprandial insulin as key factors influencing stroke risk. Higher fasting insulin levels were associated with reduced risk, while increased postprandial insulin and age were linked to higher risk. Blood glucose, cholesterol, and triglycerides had minor effects. Notably, higher total cholesterol and triglyceride levels were slightly associated with lower stroke occurrence. Further research with larger samples is needed for validation.
引言
中风是一种严重的医学病症,其特征是脑部血液供应突然中断,导致脑细胞死亡。它是全球长期残疾和死亡的主要原因。中风有一些相关的风险因素,包括可改变的和不可改变的因素。至于不可改变的风险因素,有年龄、性别(男性更易患病)和中风家族史。可控或可调节的风险因素包括高血压、糖尿病、吸烟、高胆固醇水平、肥胖和胰岛素抵抗。
方法
在我们的研究中,我们收集了229例患者的数据,这些数据最初是为临床目的收集的,并进行了回顾性分析。这些数据包含性别、年龄、缺血性心脏病(IHD)或中风病史以及不同血糖读数等特征。这些测量包括空腹血糖(FBS)、餐后血糖(PPBS)、糖化血红蛋白(HbA1c%)以及胰岛素水平(空腹和餐后)。此外,还检测了胆固醇,如总胆固醇、甘油三酯(TGL)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和极低密度脂蛋白(VLDL)。令人惊讶的是,在205例患者中有24例发生了中风。这种差异使我们关注中风与胰岛素水平之间关联的可能性。鉴于我们的结果变量(中风发生情况)性质不均衡,主要分析方法将是逻辑回归。
结果
在这项横断面研究中,我们在一个包含229例患者的数据集中研究了高胰岛素水平(空腹和餐后)与中风发生之间的关联。在纳入的229例病例中,102例为女性(44.5%),127例为男性(55.5%)。24例患有缺血性心脏病(10.5%)。在分析的病例中,24例有中风病史。样本的平均年龄约为57岁±14.87。在大多数描述性统计中,男性和女性之间没有显著差异。然而,女性的餐后血糖水平显著较高,餐后胰岛素水平显著较低。根据我们的预测模型,我们发现空腹胰岛素水平升高与中风发生风险降低有关。另一方面,餐后胰岛素水平升高和年龄增加与中风风险增加有关。
结论
我们的研究确定年龄、空腹胰岛素和餐后胰岛素是影响中风风险的关键因素。空腹胰岛素水平较高与风险降低相关,而餐后胰岛素水平升高和年龄增加与风险较高相关。血糖、胆固醇和甘油三酯的影响较小。值得注意的是,总胆固醇和甘油三酯水平较高与中风发生率略低有关。需要更大样本的进一步研究来验证。