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Abstract
Insulin resistance is associated with the occurrence of stroke and atherosclerotic disease. However, the relationship between insulin resistance and the prognosis of acute ischemic stroke in non-diabetic patients is unclear. We hypothesized that insulin resistance might affect short-term functional recovery after acute ischemic stroke in non-diabetic patients. Between May 2014 and December 2016, 1377 consecutive patients with acute ischemic stroke were enrolled from a prospectively maintained stroke registry. After excluding patients with transient ischemic attacks (TIA), pre-stroke disabilities, diabetes mellitus, and patients with incomplete evaluations, 517 patients were included in the study. The homeostasis model assessment of insulin resistance (HOMA-IR) score was used to evaluate the degree of insulin resistance. The patients with the highest quartile of log HOMA-IR index scores were younger and had higher fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein, and HbA1c levels. Multivariable logistic regression analysis revealed that log HOMA-IR scores were independently associated with poor prognosis after adjusting for age and sex and p < 0.1 in univariable analysis. Insulin resistance was associated with the poor functional outcome of non-diabetic stroke patients. This evidence supports treating insulin resistance in acute ischemic stroke patients with blood glucose levels within the normal range.
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Details
1 Ewha Womans University Mokdong Hospital and Ewha University College of Medicine, Department of Neurology, Seoul, South Korea (GRID:grid.411076.5)
2 Korea University Guro Hospital and Korea University College of Medicine, Department of Neurology, Seoul, South Korea (GRID:grid.411134.2) (ISNI:0000 0004 0474 0479)
3 Sungkyunkwan University School of Medicine, Department of Neurology, Samsung Medical Center, Seoul, South Korea (GRID:grid.264381.a) (ISNI:0000 0001 2181 989X)