Impact of diabetes and prediabetes on the short-term prognosis in patients with acute ischemic stroke

摘要

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 14 days 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.