AIMS: We aimed to investigate the effect of glycemic variability in the acute stage of stroke on the development of post-stroke cognitive impairment (PSCI). METHODS: Patients who underwent blood glucose tests at least five times within 7 days after acute ischemic stroke were included. Factors related to glycemic variability (standard deviation (SD), coefficient of variance (CV), and mean absolute glucose (MAG)) were calculated; neuropsychological assessments were administered 3 months after stroke. PSCI was defined as a score of less than -2 SDs for age-, sex-, and education-adjusted means in at least one cognitive domain. RESULTS: A total of 354 patients were enrolled. PSCI was identified in 74 (20.9%) subjects. In the diabetic group (n = 87), MAG was a significant predictor for PSCI (adjusted OR, 1.94; 95% CI, 1.11-3.42); however, it was not significant in the non-diabetic group, although PSCI exhibited an increasing tendency within higher SD and MAG tertiles. Moreover, hyperglycemia demonstrated a detrimental effect on PSCI, regardless of diabetes status; this effect did not appear in poorly-controlled diabetic patients with HbA1c ≥ 8.0%. CONCLUSIONS: Glycemic variability and hyperglycemia during acute ischemic stroke were identified as novel predictors for PSCI. Although this result is not evidence of a causal relationship, our study suggests that monitoring glycemic index and controlling its variability during the acute phase of ischemic stroke may help to prevent poor cognitive outcomes.
AIMS: We aimed to investigate the effect of glycemic variability in the acute stage of stroke on the development of post-stroke cognitive impairment (PSCI). METHODS:Patients who underwent blood glucose tests at least five times within 7 days after acute ischemic stroke were included. Factors related to glycemic variability (standard deviation (SD), coefficient of variance (CV), and mean absolute glucose (MAG)) were calculated; neuropsychological assessments were administered 3 months after stroke. PSCI was defined as a score of less than -2 SDs for age-, sex-, and education-adjusted means in at least one cognitive domain. RESULTS: A total of 354 patients were enrolled. PSCI was identified in 74 (20.9%) subjects. In the diabetic group (n = 87), MAG was a significant predictor for PSCI (adjusted OR, 1.94; 95% CI, 1.11-3.42); however, it was not significant in the non-diabetic group, although PSCI exhibited an increasing tendency within higher SD and MAG tertiles. Moreover, hyperglycemia demonstrated a detrimental effect on PSCI, regardless of diabetes status; this effect did not appear in poorly-controlled diabeticpatients with HbA1c ≥ 8.0%. CONCLUSIONS: Glycemic variability and hyperglycemia during acute ischemic stroke were identified as novel predictors for PSCI. Although this result is not evidence of a causal relationship, our study suggests that monitoring glycemic index and controlling its variability during the acute phase of ischemic stroke may help to prevent poor cognitive outcomes.
Authors: Minwoo Lee; Jae-Sung Lim; Yerim Kim; Ju Hun Lee; Chul-Ho Kim; Sang-Hwa Lee; Min Uk Jang; Mi Sun Oh; Byung-Chul Lee; Kyung-Ho Yu Journal: Brain Sci Date: 2021-05-11
Authors: Minwoo Lee; Jae-Sung Lim; Chul-Ho Kim; Sang-Hwa Lee; Yerim Kim; Ju Hun Lee; Min Uk Jang; Mi Sun Oh; Byung-Chul Lee; Kyung-Ho Yu Journal: Front Neurol Date: 2021-07-01 Impact factor: 4.003
Authors: Blanca Fuentes; Silvia Pastor-Yborra; Raquel Gutiérrez-Zúñiga; Noemí González-Pérez de Villar; Elena de Celis; Jorge Rodríguez-Pardo; Mari Carmen Gómez-de Frutos; Fernando Laso-García; María Gutiérrez-Fernández; MÁngeles Ortega-Casarrubios; Alfonso Soto; María López-Fernández; María Santamaría; Noemí Díez-González; Mar M Freijo; Beatriz Zandio; Raquel Delgado-Mederos; Ana Calleja; Juan Carlos Portilla-Cuenca; Arturo Lisbona; Laura Otero-Ortega; Exuperio Díez-Tejedor Journal: J Transl Med Date: 2020-11-04 Impact factor: 5.531