Stefanie Hägg1, Lena M Thorn1, Carol M Forsblom1, Daniel Gordin1, Markku Saraheimo1, Nina Tolonen1, Johan Wadén1, Ron Liebkind1, Jukka Putaala1, Turgut Tatlisumak1, Per-Henrik Groop2. 1. From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.). 2. From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.). per-henrik.groop@helsinki.fi.
Abstract
BACKGROUND AND PURPOSE: Despite the fact that patients with type 1 diabetes mellitus have a markedly increased risk of experiencing a stroke, independent risk factors for stroke and its subtypes in these patients have remained unclear. METHODS: A total of 4083 patients with type 1 diabetes mellitus from the Finnish Diabetic Nephropathy (FinnDiane) Study, without a history of stroke at baseline, were included. Strokes were classified based on medical files and brain imaging. At baseline, mean age was 37.4±11.8 years, duration of diabetes mellitus was 20.0 (11.0-30.0) years, and 51% were men. During 9.0±2.7 years (36 680 patient-years) of follow-up, 105 patients experienced an ischemic stroke and 44 a hemorrhagic stroke. Cox proportional hazards analyses were performed to determine independent risk factors. RESULTS: Independent risk factors for ischemic stroke were duration of diabetes mellitus, presence of diabetic nephropathy, higher hemoglobin A1c, higher systolic blood pressure, insulin resistance, and history of smoking, whereas sex, lipids, high-sensitivity C-reactive protein, and the metabolic syndrome were not associated with an increased risk. Diabetic nephropathy, severe diabetic retinopathy, higher systolic blood pressure, and lower body mass index were independently associated with hemorrhagic stroke. CONCLUSIONS: The risk factor profile for ischemic stroke seems partly different from that of hemorrhagic stroke in patients with type 1 diabetes mellitus.
BACKGROUND AND PURPOSE: Despite the fact that patients with type 1 diabetes mellitus have a markedly increased risk of experiencing a stroke, independent risk factors for stroke and its subtypes in these patients have remained unclear. METHODS: A total of 4083 patients with type 1 diabetes mellitus from the Finnish Diabetic Nephropathy (FinnDiane) Study, without a history of stroke at baseline, were included. Strokes were classified based on medical files and brain imaging. At baseline, mean age was 37.4±11.8 years, duration of diabetes mellitus was 20.0 (11.0-30.0) years, and 51% were men. During 9.0±2.7 years (36 680 patient-years) of follow-up, 105 patients experienced an ischemic stroke and 44 a hemorrhagic stroke. Cox proportional hazards analyses were performed to determine independent risk factors. RESULTS: Independent risk factors for ischemic stroke were duration of diabetes mellitus, presence of diabetic nephropathy, higher hemoglobin A1c, higher systolic blood pressure, insulin resistance, and history of smoking, whereas sex, lipids, high-sensitivity C-reactive protein, and the metabolic syndrome were not associated with an increased risk. Diabetic nephropathy, severe diabetic retinopathy, higher systolic blood pressure, and lower body mass index were independently associated with hemorrhagic stroke. CONCLUSIONS: The risk factor profile for ischemic stroke seems partly different from that of hemorrhagic stroke in patients with type 1 diabetes mellitus.
Authors: Stefanie Hägg-Holmberg; Emma H Dahlström; Carol M Forsblom; Valma Harjutsalo; Ron Liebkind; Jukka Putaala; Turgut Tatlisumak; Per-Henrik Groop; Lena M Thorn Journal: Cardiovasc Diabetol Date: 2019-07-09 Impact factor: 9.951
Authors: John Peter Mitsios; Elif Ilhan Ekinci; Gregory Peter Mitsios; Leonid Churilov; Vincent Thijs Journal: J Am Heart Assoc Date: 2018-05-17 Impact factor: 5.501
Authors: Weronika A Szlachetka; Tiberiu A Pana; Somsak Tiamkao; Allan B Clark; Kannikar Kongbunkiat; Kittisak Sawanyawisuth; Joao H Bettencourt-Silva; Narongrit Kasemap; Mamas A Mamas; Phyo K Myint Journal: Glob Heart Date: 2020-02-06