BACKGROUND: Prior research has indicated an association between insulin resistance and stroke; we sought to determine if this association persists after adjusting for stroke risk factors, including glycemic control. METHODS: We used data from the Third National Health and Nutrition Survey (1988-1994), including participants aged > or =40 years. We assessed insulin sensitivity using the homeostasis model assessment (HOMA): HOMA = (FPGSI x FPI)/22.5, where FPGSI refers to fasting plasma glucose (mmol/l) and FPI refers to fasting plasma insulin (microU/l). Increasing HOMA indicates decreasing insulin sensitivity. We used glycosylated hemoglobin (HbA1c) to measure glycemic control. Multivariable logistic regression analysis was used to identify factors that were independently associated with stroke. RESULTS: Among 3,844 participants, 168 (4%) reported a stroke history. Participants with stroke had lower insulin sensitivity than participants without stroke: HOMA mean +/- standard deviation, 4.0 +/- 4.0 vs. 3.3 +/- 3.0; p = 0.022. HOMA was independently associated with stroke (odds ratio 1.06, 95% CI: 1.01-1.12; adjusted for age, hypertension, myocardial infarction, claudication, activity, and HbA1c). The strength of the association between HOMA and stroke was similar to the association between claudication and stroke (index R(2): 0.0032 vs. 0.0036). CONCLUSIONS: Impaired insulin sensitivity is independently associated with stroke, even after adjustment for glycemic control. Copyright (c) 2005 S. Karger AG, Basel.
BACKGROUND: Prior research has indicated an association between insulin resistance and stroke; we sought to determine if this association persists after adjusting for stroke risk factors, including glycemic control. METHODS: We used data from the Third National Health and Nutrition Survey (1988-1994), including participants aged > or =40 years. We assessed insulin sensitivity using the homeostasis model assessment (HOMA): HOMA = (FPGSI x FPI)/22.5, where FPGSI refers to fasting plasma glucose (mmol/l) and FPI refers to fasting plasma insulin (microU/l). Increasing HOMA indicates decreasing insulin sensitivity. We used glycosylated hemoglobin (HbA1c) to measure glycemic control. Multivariable logistic regression analysis was used to identify factors that were independently associated with stroke. RESULTS: Among 3,844 participants, 168 (4%) reported a stroke history. Participants with stroke had lower insulin sensitivity than participants without stroke: HOMA mean +/- standard deviation, 4.0 +/- 4.0 vs. 3.3 +/- 3.0; p = 0.022. HOMA was independently associated with stroke (odds ratio 1.06, 95% CI: 1.01-1.12; adjusted for age, hypertension, myocardial infarction, claudication, activity, and HbA1c). The strength of the association between HOMA and stroke was similar to the association between claudication and stroke (index R(2): 0.0032 vs. 0.0036). CONCLUSIONS:Impaired insulin sensitivity is independently associated with stroke, even after adjustment for glycemic control. Copyright (c) 2005 S. Karger AG, Basel.
Authors: Viktória Havasi; Zoltán Szolnoki; Gábor Talián; Judit Bene; Katalin Komlósi; Anita Maász; Ferenc Somogyvári; András Kondacs; Mihály Szabó; Lajos Fodor; Anita Bodor; Béla Melegh Journal: J Mol Neurosci Date: 2006 Impact factor: 3.444
Authors: George Howard; Lynne E Wagenknecht; Walter N Kernan; Mary Cushman; Evan L Thacker; Suzanne E Judd; Virginia J Howard; Brett M Kissela Journal: Stroke Date: 2014-06-26 Impact factor: 7.914
Authors: Hannah Gardener; Milita Crisby; Charlotte Sjoberg; Barry Hudson; Ronald Goldberg; Armando J Mendez; Clinton B Wright; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco Journal: Metab Syndr Relat Disord Date: 2012-11-05 Impact factor: 1.894