Beyond hyperglycemia: glycaemic variability as a prognostic factor after acute ischemic stroke.

Autor:	Gutiérrez-Zúñiga R; Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España., Alonso de Leciñana M; Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España., Delgado-Mederos R; Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Barcelona, España., Gállego-Cullere J; Servicio de Neurología, Complejo Hospitalario de Navarra, Pamplona, España., Rodríguez-Yáñez M; Servicio de Neurología, Hospital Clínico Universitario, Santiago de Compostela, España., Martínez-Zabaleta M; Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, España., Freijo M; Servicio de Neurología, IIS Biocruces-Bizkaia, Bilbao, España., Portilla JC; Servicio de Neurología, Hospital San Pedro de Alcántara, Cáceres, España., Gil-Núñez A; Servicio de Neurología, Hospital Universitario Gregorio Marañón, Madrid, España., Díez Sebastián J; Servicio de Bioestadística, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España., Lisbona A; Servicio de Endocrinología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España., Díez-Tejedor E; Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España., Fuentes B; Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España. Electronic address: blanca.fuentes@salud.madrid.org.
Jazyk:	angličtina
Zdroj:	Neurologia [Neurologia (Engl Ed)] 2023 Apr; Vol. 38 (3), pp. 150-158.
DOI:	10.1016/j.nrleng.2020.06.017
Abstrakt:	Introduction: Glycaemic variability (GV) refers to variations in blood glucose levels, and may affect stroke outcomes. This study aims to assess the effect of GV on acute ischaemic stroke progression. Methods: We performed an exploratory analysis of the multicentre, prospective, observational GLIAS-II study. Capillary glucose levels were measured every 4 hours during the first 48 hours after stroke, and GV was defined as the standard deviation of the mean glucose values. The primary outcomes were mortality and death or dependency at 3 months. Secondary outcomes were in-hospital complications, stroke recurrence, and the impact of the route of insulin administration on GV. Results: A total of 213 patients were included. Higher GV values were observed in patients who died (n = 16; 7.8%; 30.9 mg/dL vs 23.3 mg/dL; p = 0.05). In a logistic regression analysis adjusted for age and comorbidity, both GV (OR = 1.03; 95% CI, 1.003-1.06; p = 0.03) and stroke severity (OR = 1.12; 95% CI, 1.04-1.2; p = 0.004) were independently associated with mortality at 3 months. No association was found between GV and the other outcomes. Patients receiving subcutaneous insulin showed higher GV than those treated with intravenous insulin (38.95 mg/dL vs 21.34 mg/dL; p < 0.001). Conclusions: High GV values during the first 48 hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration. (Copyright © 2020 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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