Tang Tao, Zhao Xu-Sheng, Chen Zhong-Jun, Fan Tie-Ping, Thomas Aline M, Zhao Man-Hong, Li Di, Li Shen
Department of Neurology and Psychiatry, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Neurointervention, Dalian Municipal Central Hospital, Dalian, China.
Brain Circ. 2024 Dec 28;10(4):324-329. doi: 10.4103/bc.bc_28_24. eCollection 2024 Oct-Dec.
Insulin resistance is more prevalent in the overweight population, which can affect their glucose metabolism. This study explores whether weight status influences the relationship between admission hyperglycemia and outcomes after thrombectomy.
Four hundred and fifty-two patients with acute anterior circulation ischemic stroke undergoing thrombectomy were retrospectively analyzed. Hyperglycemia at admission was described as venous blood glucose ≥7.8 mmol/L and overweight as body mass index ≥24 kg/m. The outcomes included the rates of functional independence (90-day modified Rankin Scale 0-2), symptomatic intracranial hemorrhage within 24 h after thrombectomy, and mortality at 90 days.
Overall, hyperglycemia at admission decreased the likelihood of functional independence (adjusted odds ratio [OR] 0.50, 95% confidence interval [CI] 0.30-0.83, = 0.008). Weight status modified the efficacy of admission hyperglycemia on functional independence ( = 0.022 for interaction). Hyperglycemia at admission was negatively associated with functional independence among overweight patients (adjusted OR 0.30, 95% CI 0.15-0.60, = 0.001) but not among normal-weight patients (adjusted OR 1.13, 95% CI 0.48-2.70, = 0.776). Weight status did not influence the efficacy of hyperglycemia at admission on mortality ( = 0.201 for interaction) or symptomatic intracerebral hemorrhage ( = 0.105 for interaction).
Weight status influenced the effect of hyperglycemia at admission on functional independence after thrombectomy. Hyperglycemia at admission was related to functional independence among overweight patients but not among normal-weight patients. Our findings suggest tight control of glucose may be needed for overweight patients in the thrombectomy setting.
胰岛素抵抗在超重人群中更为普遍，这会影响他们的糖代谢。本研究探讨体重状况是否会影响血管内血栓切除术患者入院时高血糖与术后结局之间的关系。
回顾性分析452例行血管内血栓切除术的急性前循环缺血性卒中患者。入院时高血糖定义为静脉血糖≥7.8 mmol/L，超重定义为体重指数≥24 kg/m²。结局指标包括功能独立率（90天改良Rankin量表评分为0 - 2分）、血栓切除术后24小时内症状性颅内出血以及90天死亡率。
总体而言，入院时高血糖降低了功能独立的可能性（校正比值比[OR]为0.50，95%置信区间[CI]为0.30 - 0.83，P = 0.008）。体重状况改变了入院时高血糖对功能独立的影响（交互作用P = 0.022）。入院时高血糖与超重患者的功能独立呈负相关（校正OR为0.30，95%CI为0.15 - 0.60，P = 0.001），而与正常体重患者无关（校正OR为1.13，95%CI为0.48 - 2.70，P = 0.776）。体重状况不影响入院时高血糖对死亡率（交互作用P = 0.201）或症状性脑出血（交互作用P = 0.105）的影响。
体重状况影响了血管内血栓切除术后入院时高血糖对功能独立的影响。入院时高血糖与超重患者的功能独立有关，而与正常体重患者无关。我们的研究结果表明，在血管内血栓切除术治疗的超重患者中可能需要严格控制血糖。
