Insulin resistance and classic risk factors in type 2 diabetic patients with different subtypes of ischemic stroke.

DOI PDF 被引用文献8件
  • K Matsumoto
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • S Miyake
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • M Yano
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • Y Ueki
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • A Miyazaki
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • K Hirao
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.
  • Y Tominaga
    Department of Internal Medicine, Sasebo Chuo Hospital, Nagasaki, Japan.

抄録

<jats:p>OBJECTIVE: In addition to classic risk factors (e.g., hypertension), insulin resistance is an important risk factor for the development of atherosclerosis. To investigate the risk factors for ischemic stroke in type 2 diabetes, we measured insulin sensitivity and several risk factors in 94 Japanese type 2 diabetic patients with different types of stroke. RESEARCH DESIGN AND METHODS: Stroke was classified by magnetic resonance imaging (MRI) and magnetic resonance (MR) angiography into the following subtypes: 1) patients with normal MRI and MR angiography (NOR; n = 30), 2) patients with lacunar infarction (LAC; n = 28), 3) patients with atherothrombotic infarction (ATI; n = 22), and 4) patients with large-artery atherosclerosis (LAA; n = 14). Insulin sensitivity was assessed by the K index of the insulin tolerance test (KITT). RESULTS: Patients with LAC, ATI, and LAA were significantly older and were more likely to be hypertensive than patients with NOR. Significantly higher insulin resistance was observed in patients with LAC, ATI, and LAA than in patients with NOR (KITT 2.21 +/- 0.17, 2.10 +/- 0.17, 2.19 +/- 0.25, and 3.25 +/- 0.21% per min, respectively, P &lt; 0.001). Adjustment for age, sex, BMI, and duration of diabetes did not influence this result. Multiple logistical regression analysis showed that insulin resistance was an independent risk factor for all subtypes of ischemic stroke in type 2 diabetic patients. The same analysis showed that a high pulse pressure was a risk factor for LAC, postprandial C-peptide (hyperinsulinemia) was a risk factor for ATI, and longstanding hyperglycemia was a risk factor for LAA.</jats:p>

収録刊行物

  • Diabetes Care

    Diabetes Care 22 (7), 1191-1195, 1999-07-01

    American Diabetes Association

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