Effect of Stress Hyperglycemia on Neurological Deficit and Mortality in the Acute Ischemic Stroke People With and Without Diabetes.
Effect of Stress Hyperglycemia on Neurological Deficit and Mortality in the Acute Ischemic Stroke People With and Without Diabetes.
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应激性高血糖对患有或不患有糖尿病的急性缺血性中风患者的神经功能缺损和死亡率的影响。
DOI：
10.3389/fneur.2020.576895
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发表时间：
2020
影响因子：
3.4
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Li J;Quan K;Wang Y;Zhao X;Li Z;Pan Y;Li H;Liu L;Wang Y
目的：探讨急性缺血性脑卒中合并和不合并糖尿病患者应激性高血糖与预后的关系。研究方法：我们分析了来自中国国家卒中登记中心II的8，622名具有基线空腹血糖和HbA 1c水平的急性缺血性卒中患者的亚组。应激性高血糖通过葡萄糖/糖化血红蛋白（HbA 1c）比值测量，该比值通过空腹血糖除以HbA 1c计算。根据病史或HbA 1c水平≥ 6.5%诊断糖尿病。结局包括重度神经功能缺损（定义为改良兰金量表评分3 - 5分）和1年时的全因死亡。分别采用Logistic回归模型和考克斯比例风险模型分析血糖/HbA 1c比值与神经功能缺损和全因死亡的关系。分别对有或无糖尿病的参与者进行亚组分析。结果：1,189例（13.7%）患者有严重神经功能缺损，678例（7.9%）患者在1年内死亡。与最低四分位数相比，葡萄糖/HbA 1c比值的最高四分位数与神经功能缺损恶化的风险升高相关（20.1% vs. 13.0%;校正OR，1.83; 95%CI，1.31-2.54，p = 0.001），死亡率（12.1% vs. 6.6%;调整后的HR，2.04; 95% CI，1.47-2.83，p < 0.0001）。血糖/HbA 1c比值与神经功能缺损的相关性在有糖尿病和无糖尿病的参与者中仍然存在，而仅在无糖尿病的参与者中对死亡率的结局具有显著性。结论：急性缺血性脑卒中患者应激性高血糖（以血糖/HbA 1c比值衡量）与1年内严重神经功能缺损和死亡风险增加相关。
Objective: To determine the relationship between stress hyperglycemia and prognosis of acute ischemic stroke people with and without diabetes. Methods: A subgroup of 8,622 acute ischemic stroke people with baseline levels of fasting blood glucose and HbA1c from the China National Stroke Registry II were analyzed. Stress hyperglycemia was measured by glucose/glycated hemoglobin (HbA1c) ratio, calculated by fasting blood glucose divided by HbA1c. Diabetes was diagnosed according to medical history or a HbA1c level of ≥6.5%. The outcomes included severe neurological deficit defined as modified Rankin Scale score of 3 to 5 and all-cause death at 1 year. The associations between glucose/HbA1c ratio and neurological deficit and all-cause death were analyzed via logistic regression model and Cox proportional-hazards model, respectively. Subgroup analyses of participants with or without diabetes were performed separately. Results: Totally 1,189 (13.7%) participants had severe neurological deficit, and 678 (7.9%) died within 1 year. Compared with the lowest quartile, the highest quartiles of glucose/HbA1c ratio were associated with elevated risk of worse neurological deficit (20.1% vs. 13.0%; adjusted OR, 1.83; 95%CI, 1.31–2.54, p = 0.001), and mortality (12.1% vs. 6.6%; adjusted HR, 2.04; 95% CI, 1.47–2.83, p < 0.0001) after adjusted for potential covariates. The association of glucose/HbA1c ratio with neurological deficit remained in the participants with and without diabetes, while it was only significant in the participants without diabetes as for the outcome of mortality. Conclusions: Stress hyperglycemia, measured by glucose/HbA1c ratio, was associated with increased risk of severe neurological deficit and mortality within 1 year in the acute ischemic stroke people.
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影响因子：
7.2
作者：
Su, Y. -W.;Hsu, C. -Y.;Chen, H. -S.
通讯作者：
Chen, H. -S.
空腹血糖升高可以预测非糖尿病中风患者的预后不良：SMART的亚组分析。
影响因子：
3.7
作者：
Yao M;Ni J;Zhou L;Peng B;Zhu Y;Cui L;SMART investigators
通讯作者：
SMART investigators
影响因子：
2.9
作者：
Gu HQ;Li ZX;Zhao XQ;Liu LP;Li H;Wang CJ;Yang X;Rao ZZ;Wang CX;Pan YS;Wang YL;Wang YJ;China National Stroke Registries
通讯作者：
China National Stroke Registries
影响因子：
8.3
作者：
Yang, Xiaomeng;Li, Zixiao;Wang, Yongjun
通讯作者：
Wang, Yongjun
影响因子：
3.5
作者：
Stead, Latha G.;Gilmore, Rachel M.;Brown, Robert D., Jr.
通讯作者：
Brown, Robert D., Jr.