Dataset Information

Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients.

ABSTRACT:

Background

Diabetes mellitus is a well-established risk factor for ischemic stroke and is known to increase stroke risk by 2-6 fold. Numerous studies have reported the relationship between parameters for glycemic status and stroke-related outcomes; however, studies focusing on the interaction between acute and chronic glycemic status indexes with stroke phenotype are lacking.

Methods

Acute ischemic stroke patients who were admitted to a tertiary hospital stroke center from 2002 to 2015 were consecutively enrolled in this study. Fasting blood sugar (FBS) and serum glycated hemoglobin (HbA1c) levels were recorded as acute and chronic glycemic indexes, respectively. The associations between initial stroke severity and both glycemic indexes were evaluated with consideration of the interaction between the glycemic indexes. Moreover, the distinct effects of stroke subtypes were evaluated.

Results

A total of 2595 patients were included in the final analysis. After adjustment for covariates, FBS was associated with initial stroke severity (P?ConclusionsThis study shows that HbA1c is an effect modifier for the association between FBS and initial stroke severity, and the interactive effect differs among stroke subtypes.

SUBMITTER: Lee KJ

PROVIDER: S-EPMC6091005 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients.

Lee Keon-Joo KJ Lee Ji Sung JS Jung Keun-Hwa KH

BMC neurology 20180803 1

<h4>Background</h4>Diabetes mellitus is a well-established risk factor for ischemic stroke and is known to increase stroke risk by 2-6 fold. Numerous studies have reported the relationship between parameters for glycemic status and stroke-related outcomes; however, studies focusing on the interaction between acute and chronic glycemic status indexes with stroke phenotype are lacking.<h4>Methods</h4>Acute ischemic stroke patients who were admitted to a tertiary hospital stroke center from 2002 to ...[more]

PMID: 30075761

Similar Datasets

Project description:Background: Ischemic stroke causes increased blood-brain barrier permeability and release of markers of axonal damage and inflammation. To investigate diagnostic and prognostic roles of neurofilament light chain (NF-L), we assessed levels of NF-L, S100B, interleukin-6 (IL-6), E-selectin, vascular endothelial growth factor-A (VEGF-A), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) in patients with acute ischemic stroke or transient ischemic attack (TIA) and healthy controls. Methods: We studied neurofilament (NF) expression in 2 cases of human postmortem ischemic stroke, representing infarcts aged 3- to >7-days. In a prospective study, we measured plasma NF-L and inflammatory markers <8 h of symptom onset and at 72 h in acute ischemic stroke (n = 31), TIA (n = 9), and healthy controls (n = 29). We assessed whether NF-L, S100B, and IL-6 were associated with clinical severity on admission (Scandinavian Stroke Scale, SSS), diagnosis of ischemic stroke vs. TIA, and functional outcome at 3 months (modified Rankin Scale, mRS). Results: NF expression increased in ischemic neurons and in the infarcted brain parenchyma after stroke. Plasma NF-L levels were higher in stroke patients than in TIA patients and healthy controls, but IL-6 levels were similar. Higher acute NF-L levels were associated with lower SSS scores at admission and higher mRS scores at 3 months. No correlation was observed between NF-L and S100B, NF-L and IL-6, nor between S100B or IL-6 and SSS or mRS. Compared to controls, stroke patients had significantly higher VEGF-A and VCAM-1 at <8 h that remained elevated at 72 h, with significantly higher VEGF-A at <8 h; ICAM-1 was significantly increased at <8 h, while S100B and E-selectin were unchanged. Conclusions: Plasma NF-L levels, but not IL-6 and S100B, were significant predictors of clinical severity on admission and functional outcome at 3 months. Plasma NF-L is a promising biomarker of functional outcome after ischemic stroke.

Project description:(1) Introduction: Iron deficiency (ID) contributes to impaired functional performance and reduced quality of life in patients with chronic illnesses. The role of ID in stroke is unclear. The aim of this prospective study was to evaluate the prevalence of ID and to evaluate its association with long-term functional outcome in patients with ischemic stroke. (2) Patients and Methods: 140 patients (age 69 ± 13 years, BMI 27.7 ± 4.6 kg/m², mean ± SD) admitted to a university hospital stroke Unit, with acute ischemic stroke of the middle cerebral artery were consecutively recruited to this observational study. Study examinations were completed after admission (3 ± 2 days after acute stroke) and at one-year follow up (N = 64, 382 ± 27 days after stroke). Neurological status was evaluated according to the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin scale (mRS). Muscle isometric strength of the non-affected limb was assessed by the maximum handgrip test and knee extension leg test. ID was diagnosed with serum ferritin levels ≤ 100 µg/L (ID Type I) or 100-300 µg/L if transferrin saturation (TSAT) < 20% (ID Type II). (3) Results: The prevalence of ID in acute stroke patients was 48% (N = 67), with about two-thirds of patients (N = 45) displaying ID Type I and one-third (N = 22) Type II. Handgrip strength (HGS) and quadriceps muscle strength were reduced in patients with ID compared to patients without ID at baseline (HGS: 26.5 ± 10.4 vs. 33.8 ± 13.2 kg, p < 0.001 and quadriceps: 332 ± 130 vs. 391 ± 143 N, p = 0.06). One year after stroke, prevalence of ID increased to 77% (p = 0.001). While an improvement of HGS was observed in patients with normal iron status, patients with ID had no improvement in HGS difference (4.6 ± 8.3 vs. -0.7 ± 6.5 kg, p < 0.05). Patients with ID remained with lower HGS compared to patients with normal iron status (28.2 ± 12.5 vs. 44.0 ± 8.6 kg, p < 0.0001). (4) Conclusions: Prevalence of ID was high in patients after acute stroke and further increased one year after stroke. ID was associated with lower muscle strength in acute stroke patients. In patients with ID, skeletal muscle strength did not improve one year after stroke.

Dataset Information

Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients.

Background

Methods

Results

Publications

Interactive effect of acute and chronic glycemic indexes for severity in acute ischemic stroke patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets