Hyperglycemia and incidence of ischemic and hemorrhagic stroke-comparison between fasting and 2-hour glucose criteria.

Abstract

BACKGROUND AND PURPOSE:

We examined the impact of hyperglycemia on ischemic and hemorrhagic stroke incidence comparing criteria based on fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hour PG).

METHODS:

Data from 9 European cohorts comprising 18 360 individuals between 25 to 90 years of age were collaboratively analyzed. The maximum length of follow-up varied between 4.9 to 36.8 years. Hazards ratios (95% confidence intervals) for stroke incidence were estimated using Cox-proportional hazards model adjusting for known risk factors.

RESULTS:

In individuals without a prior history of diabetes, the multivariate-adjusted hazards ratio for ischemic stroke corresponding to 1 SD increase in FPG was 1.12 (1.02 to 1.22) and in 2-hour PG 1.14 (1.05 to 1.24). Adding 2-hour PG to the model with FPG significantly improved the prediction of the model for the incidence of ischemic stroke (chi(2)=4.72, P=0.03), whereas FPG did not improve the 2-hour PG model prediction (chi(2)=0.25, P=0.62). A significantly increased hazard ratio was also observed for previously diagnosed diabetes (2.26 [1.51 to 3.38]) and for screen-detected diabetes defined by FPG (1.48 [1.08 to 2.02]) and 2-hour PG (1.60 [1.18 to 2.16]). None of the criteria predicted hemorrhagic stroke.

CONCLUSIONS:

Diabetes defined by either of the criteria predicted the future risk of ischemic stroke but not the hemorrhagic stroke. The prediction is stronger for elevated 2-hour PG than for FPG levels.

• Authors: Marjukka Hyvärinen, Jaakko Tuomilehto, Markku Mähönen, Coen D A Stehouwer, Kalevi Pyörälä, Björn Zethelius, Qing Qiao, DECODE Study Group
• Journal: Stroke (Stroke) Vol. 40 Issue 5 Pg. 1633-7 (May 2009) ISSN: 1524-4628 [Electronic] United States
• PMID: 19286584 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose

Topics

• Adult
• Aged
• Aged, 80 and over
• Blood Glucose (metabolism)
• Brain Ischemia (complications, epidemiology)
• Cerebral Hemorrhage (complications, epidemiology)
• Data Interpretation, Statistical
• Diabetes Complications (epidemiology)
• Fasting (blood)
• Female
• Finland (epidemiology)
• Humans
• Hyperglycemia (blood, epidemiology)
• Male
• Middle Aged
• Proportional Hazards Models
• Stroke (blood, epidemiology, etiology)
• Sweden (epidemiology)