Objective: We aimed to explore the association between abnormal glucose metabolism such as diabetes, prediabetes, and short-term prognosis in patients with acute ischemic stroke.
Methods: Of 242 consecutive acute ischemic stroke patients, a 75-g oral glucose tolerance test was administered to 116 patients without previously diagnosed diabetes. One hundred forty patients were classified into diabetes, 52 patients were prediabetes (impaired glucose tolerance or impaired fasting glucose or both), and 50 patients were normal glucose tolerance (NGT). The association between each glycemic status and early neurological deterioration (END; increase in the NIH Stroke Scale (NIHSS) of ≥2 points during the first 14days after admission) or poor short-term outcome (30-day modified Ranking Scale [mRS] score 2-6) was evaluated.
Results: In multivariable analysis, the risk of END was significantly higher in the diabetes group than in the NGT group (ORs=11.354; 95% CI, 1.492-86.415; p=0.019), even after adjustment for possible confounding factors (ORs=12.769; 95% CI, 1.361-119.763; p=0.026). Similar but insignificant associations were observed between prediabetes and NGT groups (ORs=6.369; 95% CI, 0.735-55.177; p=0.093). The risk of poor outcome (30-day mRS 2-6) was significantly higher in the diabetes group (ORs=3.667; 95% CI, 1.834-7.334; p<0.001) than in the NGT group, even after adjusting for confounding factors (ORs=3.340; 95% CI, 1.361-8.195; p=0.008). Similar but insignificant associations were observed between prediabetes and NGT groups (ORs=2.058; 95% CI, 0.916-4.623; p=0.08).
Conclusion: In our patient population, both diabetes and prediabetes were associated with a poor early prognosis after acute ischemic stroke.
Keywords: AGM; ATI; Acute stroke; BAD; BMI; CE; CT; DL; DM; Diabetes; END; Early neurological deterioration; HDL; HT; IFG; IGT; LDL; LI; MRI; NGT; NIHSS; National Institutes of Health Stroke Scale; OGTT; Oral glucose tolerance test; Prediabetes; RS; TIA; UE; Worse prognosis; abnormal glucose metabolism; atherothrombotic infarction; cardioembolic infarction; computed tomography; diabetes mellitus; dyslipidemia; early neurological deterioration; high density lipoprotein; high-body mass index; hypertension; impaired fasting glucose; impaired glucose tolerance; in-hospital recurrence of stroke; intracranial branch atheromatous disease; lacunar infarction; low density lipoprotein; mRS; magnetic resonance imaging; modified Ranking Scale; normal glucose tolerance; oral glucose tolerance test; preDM; prediabetes; transient ischemic attack; undetermined etiology.
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