Elevated stress hyperglycemia and the presence of intracranial artery stenosis increase the risk of recurrent stroke

作者：Yongle Wang, Hongxuan Fan, Weiying Duan, Ren Zhaoyu, Xuchang Liu, Tingting Liu, Yanan Li, Kaili Zhang, Haimei Fan, Jing Ren, Juan Li, Xinyi Li, Xuemei Wu, Xiaoyuan Niu · 发表于：Frontiers in Endocrinology · 年份：2023 · DOI：10.3389/fendo.2022.954916 · 被引用次数：15 · 研究领域：Neurological and metabolic disorders、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Diabetic Foot Ulcer Assessment and Management

Background: Stress hyperglycemia has served as a reliable biomarker to predict poor outcomes after ischemic stroke. However, recent studies have reported some contrary conclusions. Different stroke subtypes may respond inconsistently to stress hyperglycemia. The progression of intracranial atherosclerotic stenosis (ICAS) is tightly related to hyperglycemia. Thus, this study aims to determine the relationship between stress hyperglycemia and recurrent stroke in ischemic stroke patients with or without intracranial atherosclerotic stenosis. Methods: This is a multicenter retrospective observational cohort study. Patients with acute minor ischemic stroke and eligible computed tomography and magnetic resonance imaging data were enrolled. The severity of stress hyperglycemia is measured by the stress hyperglycemia ratio (SHR). SHR was calculated based on fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels. The primary outcome was stroke recurrence during hospitalization. The interaction of SHR levels with the presence of ICAS on the primary outcome was investigated using univariable and multivariable Cox proportional hazards models. Restricted cubic splines were applied to determine the nonlinear relationship between SHR and primary outcome. A two-piecewise linear regression model was used to identify the threshold of SHR. Results: A total of 610 participants were included in the study. The average age of the patients was 61.4 ± 12.9 years old, and approximately 70% of ...