South Korea: Researchers have found in a new study that Insulin resistance measured by the HOMA-IR index was associated with the poor functional outcome of non-diabetic stroke patients.
Therefore acute ischemic stroke patients with normal blood sugar levels should be evaluated for insulin resistance, finds a recent study in the journal Scientific Reports. However, according to the authors, these data will need to be replicated in larger cohorts.
Insulin resistance is associated with the occurrence of atherosclerotic disease and stroke. However, there is a lack of clarity on the relationship between insulin resistance and the prognosis of acute ischemic stroke in non-diabetic patients. Kyungmi Oh, Korea University Guro Hospital and Korea University College of Medicine, Seoul, South Korea, and colleagues hypothesized that insulin resistance might affect short-term functional recovery after acute ischemic stroke in non-diabetic patients.
The study enrolled 1377 consecutive patients with acute ischemic stroke from a prospectively maintained stroke registry between May 2014 and December 2016. 517 patients were included in the study after excluding patients with transient ischemic attacks (TIA), pre-stroke disabilities, diabetes mellitus, and patients with incomplete evaluations
The homeostasis model assessment of insulin resistance (HOMA-IR) score was used to evaluate the degree of insulin resistance.
Key findings of the study include:
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.
"Insulin resistance measured by the HOMA-IR index was associated with the poor functional outcome of non-diabetic stroke patients," wrote the authors. "This finding may strengthen the need to treat insulin resistance itself in acute ischemic stroke patients with blood glucose levels within the normal range."
The study titled, "Insulin resistance is associated with poor functional outcome after acute ischemic stroke in non-diabetic patients," is published in the journal Scientific Reports.
DOI: https://www.nature.com/articles/s41598-020-80315-z