β-Cell Function and Clinical Outcome in Nondiabetic Patients With Acute Ischemic Stroke
β-Cell Function and Clinical Outcome in Nondiabetic Patients With Acute Ischemic Stroke
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DOI：
10.1161/strokeaha.120.031392
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发表时间：
2021-08-01
期刊：
影响因子：
8.3
通讯作者：
Ago, Tetsuro
中科院分区：
文献类型：
--
作者：
Kiyohara, Takuya;Matsuo, Ryu;Ago, Tetsuro
背景和目的：关于β细胞功能障碍如何影响缺血性卒中后的临床结局知之甚少。我们研究了β细胞功能是否与急性缺血性卒中后的临床结局相关，如果是这样，胰岛素抵抗是否会影响这种关联在一项前瞻性研究中的急性stroke.METHODS：共3590例非糖尿病急性缺血性卒中患者（平均年龄71岁）进行了为期3个月的随访。使用β-细胞功能的稳态模型评估（HOMA-β）评估β-细胞功能。研究结局为功能结局差（改良兰金量表评分，3-6分）和卒中发作后3个月的卒中复发以及出院时的神经功能恶化（国立卫生研究院卒中量表评分增加>= 2分）。Logistic回归分析用于评估血清HOMA-β五分位水平与临床结局之间的关系。结果：随着HOMA-β水平的降低，功能结局差和神经功能恶化的年龄和性别校正比值比显著增加（P趋势，
BACKGROUND AND PURPOSE: Little is known about how beta-cell dysfunction affects clinical outcome after ischemic stroke. We examined whether beta-cell function is associated with clinical outcome after acute ischemic stroke and if so, whether insulin resistance influences this association in a prospective study of patients with acute stroke.METHODS: A total of 3590 nondiabetic patients with acute ischemic stroke (mean age, 71 years) were followed up for 3 months. beta-Cell function was assessed using the homeostasis model assessment for beta-cell function (HOMA-beta). Study outcomes were poor functional outcome (modified Rankin Scale score, 3-6) and stroke recurrence at 3 months after stroke onset and neurological deterioration (>= 2-point increase in the National Institutes of Health Stroke Scale score) at discharge. Logistic regression analysis was used to evaluate the association between quintile levels of serum HOMA-beta and clinical outcomes.RESULTS: The age- and sex-adjusted odds ratios for poor functional outcome and neurological deterioration increased significantly with decreasing HOMA-beta levels (P for trend,