Klin Farmakol Farm. 2005;19(4):202-205

Potential predictive significance of insulin resistance syndrome in ischemic stroke

Ivanka Vlachová¹, prof. MUDr. Helena Vaverková CSc², doc. MUDr. Roman Herzig Ph.D¹, Daniel Novotný³, MUDr. Bohdan Křupka Ph.D⁴, doc. MUDr. Věra Krčová CSc⁵, MUDr. Andrea Bártková¹, Daniel Šaňák¹, RNDr. Marie Budíková⁶, Karel Urbánek⁷, Petr Kaňovský¹

¹ Neurologická klinika FN a LF UP Olomouc

² III. interní klinika FN a LF UP Olomouc

³ Oddělení klinické biochemie, LF UP a FN, Olomouc

⁴ Neurologické oddělení, Vsetínská nemocnice a.s

⁵ Hemato-onkologická klinika FN a LF UP v Olomouci

⁶ Imunoanalytická laboratoř KNM FN Olomouc

⁷ Ústav farmakologie LF UP a FN Olomouc

Insulin resistance syndrome (IRS), the incidence of which has been steadily rising, represents a significant risk factor of cardiovascular disease, including ischemic cerebrovascular stroke. The goal of the study was to assess its presence in the acute phase of stroke and evaluate its influence on the severity of neurologic deficit in this phase and later on.

Methods: Diagnosis of IRS was made according to NCEP-ATP III criteria including abdominal obesity (waist circumference > 102 cm in men, > 88 cm in women), triglycerides ≥ 1.7 mmol/l, HDL-cholesterol <1.0 mmol/l in men and <1.3 mmol/l in women, BP ≥130/≥85 mmHg, fasting glucose level ≥6.1 mmol/l. The diagnosis was based on the presence of 3 or more risk determinants. Hypertriglyceridemic hyperapo-B corresponds to triglycerides ≥1.7 mmol/l and apo-B ≥1.2 mmol/l. The investigated group included 111 probands (65 men and 46 women), mean age 60.2±10.4 years, in the acute phase of stroke. Glasgow outcome scale (GOS) at 3 months was assessed in 92 probands. Statistical analysis was performed using chi-square test and Pearson correlation analysis.

Results: IRS criteria were fulfilled in 64% of probands in the acute phase of stroke. In 16.2 % of probands, hypertriglyceridemic hyperapo-B was found. When considering GOS, the most influential factors were higher fasting glucose level (p=0.0002) and systolic BP (p=0.034). Correlation analysis demonstrated negative correlation between the number of IRS criteria symptoms and the GOS (r=–0.303).

Conclusion: IRS represents a significant risk factor for ischemic stroke. Increasing number of symptoms leads to increased risk, which is also demonstrated by the correlation analysis wherein more IRS symptoms have a negative impact on patient status 3 months after the acute phase of ischemic stroke.

Keywords: Key Words: ischemic stroke, metabolic syndrome insulin resistance.

Published: January 1, 2006  Show citation