Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke
Abstract Background Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke, whereas less is known about adipose tissue specific insulin resistance and outcomes after ischemic stroke. This study aimed to estimate the association between adipose tissue specific insulin resi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-023-01235-2 |
| _version_ | 1797414394771013632 |
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| author | Qi Zhou Hongyi Yan Aoming Jin Xia Meng Jinxi Lin Hao Li Yongjun Wang Yuesong Pan |
| author_facet | Qi Zhou Hongyi Yan Aoming Jin Xia Meng Jinxi Lin Hao Li Yongjun Wang Yuesong Pan |
| author_sort | Qi Zhou |
| collection | DOAJ |
| description | Abstract Background Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke, whereas less is known about adipose tissue specific insulin resistance and outcomes after ischemic stroke. This study aimed to estimate the association between adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke. Methods Patients with ischemic stroke without a history of diabetes mellitus in the Third China National Stroke Registry were included. Adipose tissue specific insulin resistance index (Adipo-IR) was calculated by fasting serum insulin and free fatty acids and categorized into 5 groups according to the quintiles. Outcomes included stroke recurrence (ischemic or hemorrhagic), combined vascular events, all-cause death, and poor outcome (modified Rankin Scale, 3–6) at 12 months after stroke onset. We assessed the association between Adipo-IR and risk of prognosis by multivariable Cox/logistic regression models adjusted for potential covariates. Results Among 2,222 patients, 69.0% were men with a mean age of 62.5 years. At 12 months, 185 (8.3%) patients had recurrent stroke, 193 (8.7%) had combined vascular events, 58 (2.6%) died, and 250 (11.5%) had a poor outcome. Compared with patients with the lowest quintile, patients with the second, third, fourth, fifth quintiles of the Adipo-IR were associated with an increased risk of stroke recurrence (hazard ratio [HR], 1.77; 95% CI, 1.04–3.03; P = 0.04; HR, 2.19; 95% CI, 1.30–3.68; P = 0.003; HR, 1.84; 95% CI, 1.06–3.21; P = 0.03; HR, 2.11; 95% CI, 1.20–3.71; P = 0.01, respectively) and marginally associated with an increased risk of combined vascular events ( HR, 1.60; 95%CI, 0.97–2.64; P = 0.07; HR, 1.91; 95% CI, 1.17–3.13; P = 0.01; HR, 1.62; 95% CI, 0.96–2.75; P = 0.07; HR, 1.80; 95% CI, 1.05–3.09; P = 0.03, respectively) at 12 months after adjustment for potential covariates. Adipo-IR was not associated with mortality and poor outcome at 12 months. Conclusions These findings suggest that adipose tissue specific insulin resistance is independently associated with recurrent stroke and combined vascular events after acute ischemic stroke in nondiabetic patients. |
| first_indexed | 2024-03-09T05:32:26Z |
| format | Article |
| id | doaj.art-8efce6aff362405f81090f87d9485ce8 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-03-09T05:32:26Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-8efce6aff362405f81090f87d9485ce82023-12-03T12:31:18ZengBMCDiabetology & Metabolic Syndrome1758-59962023-12-0115111010.1186/s13098-023-01235-2Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic strokeQi Zhou0Hongyi Yan1Aoming Jin2Xia Meng3Jinxi Lin4Hao Li5Yongjun Wang6Yuesong Pan7Department of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background Insulin resistance is linked to atherosclerotic cardiovascular diseases and stroke, whereas less is known about adipose tissue specific insulin resistance and outcomes after ischemic stroke. This study aimed to estimate the association between adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke. Methods Patients with ischemic stroke without a history of diabetes mellitus in the Third China National Stroke Registry were included. Adipose tissue specific insulin resistance index (Adipo-IR) was calculated by fasting serum insulin and free fatty acids and categorized into 5 groups according to the quintiles. Outcomes included stroke recurrence (ischemic or hemorrhagic), combined vascular events, all-cause death, and poor outcome (modified Rankin Scale, 3–6) at 12 months after stroke onset. We assessed the association between Adipo-IR and risk of prognosis by multivariable Cox/logistic regression models adjusted for potential covariates. Results Among 2,222 patients, 69.0% were men with a mean age of 62.5 years. At 12 months, 185 (8.3%) patients had recurrent stroke, 193 (8.7%) had combined vascular events, 58 (2.6%) died, and 250 (11.5%) had a poor outcome. Compared with patients with the lowest quintile, patients with the second, third, fourth, fifth quintiles of the Adipo-IR were associated with an increased risk of stroke recurrence (hazard ratio [HR], 1.77; 95% CI, 1.04–3.03; P = 0.04; HR, 2.19; 95% CI, 1.30–3.68; P = 0.003; HR, 1.84; 95% CI, 1.06–3.21; P = 0.03; HR, 2.11; 95% CI, 1.20–3.71; P = 0.01, respectively) and marginally associated with an increased risk of combined vascular events ( HR, 1.60; 95%CI, 0.97–2.64; P = 0.07; HR, 1.91; 95% CI, 1.17–3.13; P = 0.01; HR, 1.62; 95% CI, 0.96–2.75; P = 0.07; HR, 1.80; 95% CI, 1.05–3.09; P = 0.03, respectively) at 12 months after adjustment for potential covariates. Adipo-IR was not associated with mortality and poor outcome at 12 months. Conclusions These findings suggest that adipose tissue specific insulin resistance is independently associated with recurrent stroke and combined vascular events after acute ischemic stroke in nondiabetic patients.https://doi.org/10.1186/s13098-023-01235-2Adipose tissueInsulin resistanceMetabolismRiskStroke |
| spellingShingle | Qi Zhou Hongyi Yan Aoming Jin Xia Meng Jinxi Lin Hao Li Yongjun Wang Yuesong Pan Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke Diabetology & Metabolic Syndrome Adipose tissue Insulin resistance Metabolism Risk Stroke |
| title | Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| title_full | Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| title_fullStr | Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| title_full_unstemmed | Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| title_short | Adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| title_sort | adipose tissue specific insulin resistance and prognosis of nondiabetic patients with ischemic stroke |
| topic | Adipose tissue Insulin resistance Metabolism Risk Stroke |
| url | https://doi.org/10.1186/s13098-023-01235-2 |
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