Hyperglycaemia in acute lacunar stroke: A Chinese hospital-based study

Yuan, Fang; Zhang, Shihong; Wu, Bo; Liu, Ming

doi:10.1177/1479164112459663

Cited by 19 publications

(12 citation statements)

References 42 publications

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“…This result differs from the findings presented by Fang et al[ 24 ], although it is partially consistent with findings from several other previous studies[ 9 , 10 , 25 , 26 ]. Fang et al suggested that hyperglycemia was not associated with functional outcome in patients with lacunar stroke[ 24 ]. One explanation for this difference is that they measured fasting glucose levels, which may be affected by confounding variables[ 11 ].…”

Section: Discussionsupporting

confidence: 82%

Association between Elevated Hemoglobin A1c Levels and the Outcomes of Patients with Small-Artery Occlusion: A Hospital-Based Study

et al. 2016

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IntroductionAbnormal glucose metabolism is an independent risk factor for poor outcome following acute ischemic stroke. However, the relationship between initial hemoglobin A1c level and functional outcome (defined by modified Rankin Scale scores) following small-artery occlusion, a subtype of ischemic stroke, is unknown. The aim of the present study was to evaluate this association among patients diagnosed with small-artery occlusion.Materials and MethodsData on 793 patients diagnosed with small-artery occlusion from October 25, 2012 to June 30, 2015 were collected from the stroke registry of the Department of Neurorehabilitation of HuanHu Hospital. Hemoglobin A1c values at admission were classified into three groups according to tertiles (<5.9,5.9to<6.7, and≥6.7). We used receiver operating characteristics curves to investigate the predictive value of hemoglobin A1c and examined the relationship between hemoglobin A1c levels at admission and modified Rankin Scale scores using univariate and multivariate analyses.ResultsThe area under the curve was 0.570 (95%CI, 0.509–0.631; P = 0.023). Patients in the highest HbA1c stratification (≥6.7) had a significantly higher risk of an unfavorable outcome than patients in the lowest stratification (<5.9; adjusted odds ratio, 2.099; 95%CI, 1.160–3.798; P = 0.014). However, a significant association was not seen in the middle stratification (5.9 to <6.7; P = 0.115).ConclusionsElevated hemoglobin A1c level on admission was adversely associated with functional outcomes 3 months after stroke onset among patients presenting with small-artery occlusion.

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Section: Discussionsupporting

confidence: 82%

Association between Elevated Hemoglobin A1c Levels and the Outcomes of Patients with Small-Artery Occlusion: A Hospital-Based Study

et al. 2016

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“…Patients with hyperglycemia did not have larger perfusion deficits in ischaemic stroke 19 . Hyperglycemia was found not to associate with functional outcome in lacunar stroke 20 . Therefore, our finding suggested hyperglycemia can reduce the infarct volume of lacunar stroke in both the cortex and sub-cortical regions.…”

Section: Discussionmentioning

confidence: 71%

The Influence of Acute Hyperglycemia in an Animal Model of Lacunar Stroke That Is Induced by Artificial Particle Embolization

et al. 2016

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Animal and clinical studies have revealed that hyperglycemia during ischemic stroke increases the stroke's severity and the infarct size in clinical and animal studies. However, no conclusive evidence demonstrates that acute hyperglycemia worsens post-stroke outcomes and increases infarct size in lacunar stroke. In this study, we developed a rat model of lacunar stroke that was induced via the injection of artificial embolic particles during full consciousness. We then used this model to compare the acute influence of hyperglycemia in lacunar stroke and diffuse infarction, by evaluating neurologic behavior and the rate, size, and location of the infarction. The time course of the neurologic deficits was clearly recorded from immediately after induction to 24 h post-stroke in both types of stroke. We found that acute hyperglycemia aggravated the neurologic deficit in diffuse infarction at 24 h after stroke, and also aggravated the cerebral infarct. Furthermore, the infarct volumes of the basal ganglion, thalamus, hippocampus, and cerebellum but not the cortex were positively correlated with serum glucose levels. In contrast, acute hyperglycemia reduced the infarct volume and neurologic symptoms in lacunar stroke within 4 min after stroke induction, and this effect persisted for up to 24 h post-stroke. In conclusion, acute hyperglycemia aggravated the neurologic outcomes in diffuse infarction, although it significantly reduced the size of the cerebral infarct and improved the neurologic deficits in lacunar stroke.

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“…Admission hyperglycaemia was very common in AIS patients and was related to worse prognosis in non-lacunar brain infarction. The association between hyperglycaemia and clinical outcome in 689 consecutive lacunar AIS patients in a hospitalized Chinese population was investigated (11). Of them, 159 (23%) presented with diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Disorders of blood glucose levels in adult patients with acute Ischemic stroke

Arabadzhieva

Radeva

Slavov

et al. 2015

SSM

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INTRODUCTION: Effective and timely prevention of acute ischemic stroke (AIS) is characterized by a rising socio-medical importance as this is the most common cerebrovascular disease worldwide and in Bulgaria as well. Our purpose was to reveal the incidence rate of the disorders of glucose metabolism in AIS development among adult patients. MATERIAL AND METHODS: We examined 129 male and 129 female patients with AIS at a mean age of 70.59±7.22 years hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna in 2007-2013. Blood glucose concentrations at admission were examined. Statistical data processing was performed by variation (ANOVA as t-criterion was considered significant if p<0.05) and correlation (Pearson's coefficient) analyses. RESULTS: Mean fasting blood glucose levels were most commonly elevated and total ones were higher in males than in females except for the minimal value. The males with abnormally elevated blood glucose values present with higher mean and maximal values than the females. The number and relative share of the patients with increased blood glucose values at admission considerably prevailed. The difference between the number of the males with increased values and that of those with normal values was statistically significant (t=3.33; p<0.01). There was moderate correlation between the level of blood glucose and the preceding diabetes mellitus (r=0.431) and a strong one between this level and the newly-diagnosed diabetes mellitus (r=0.733) among our AIS patients. CONCLUSION: The regular control of blood glucose by the general practitioners and the promotion of the healthy lifestyle in cardiovascular disease patients could successfully prevent AIS in Bulgaria.

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Hyperglycaemia in acute lacunar stroke: A Chinese hospital-based study

Cited by 19 publications

References 42 publications

Association between Elevated Hemoglobin A1c Levels and the Outcomes of Patients with Small-Artery Occlusion: A Hospital-Based Study

Association between Elevated Hemoglobin A1c Levels and the Outcomes of Patients with Small-Artery Occlusion: A Hospital-Based Study

The Influence of Acute Hyperglycemia in an Animal Model of Lacunar Stroke That Is Induced by Artificial Particle Embolization

Disorders of blood glucose levels in adult patients with acute Ischemic stroke

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