Thresholds of risk factors for ischemic stroke in type 2 diabetic patients with and without albuminuria—A non-linear approach
| Autor: | Peter C.Y. Tong, Risa Ozaki, Ronald C.W. Ma, Vivian C. W. Wong, Wing-Yee So, Alice P. Kong, Gary T. Ko, Xilin Yang, Christopher W.K. Lam, Chung-Shun Ho, Juliana C.N. Chan, Clive S. Cockram |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Type 2 diabetes Body Mass Index Brain Ischemia Risk Factors Internal medicine Albuminuria Humans Medicine Prospective Studies Risk factor Prospective cohort study Stroke Aged business.industry Hazard ratio Hemoglobin A General Medicine Middle Aged medicine.disease Endocrinology Blood pressure Diabetes Mellitus Type 2 Nonlinear Dynamics Hypertension Cardiology Regression Analysis Female Surgery Neurology (clinical) medicine.symptom business Body mass index Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Clinical Neurology and Neurosurgery. 110:701-709 |
| ISSN: | 0303-8467 |
| Popis: | Multiple risk factors in type 2 diabetes may explain their high risk for ischemic stroke (IS). However, it remains unknown whether these risk factors exhibit threshold characteristics and whether these relationships are influenced by albuminuria. The study aims to investigate whether risk factors exhibit any albuminuria specific threshold for IS.This is a prospective cohort study with 6969 Chinese type 2 diabetic patients without history of stroke after a median follow-up of 5.36 years. We identified thresholds of risk factors for IS using hazard ratio plots followed by confirmation using traditional Cox regression analysis.In the non-albuminuric group (n=4008), IS risk started to increase rapidly at a body mass index threshold of 24 kg/m(2). The risk of IS declined with increasing blood hemoglobin reaching a threshold value of 14 g/dl. Using these threshold values as cutoff point, body mass indexor =24 kg/m(2) and hemoglobin14 g/dl were associated with 2-fold increased risk of IS in these subjects. In the albuminuric group (n=2961). IS risk started to increase rapidly from a systolic blood pressure threshold of 135 mmHg and declined with increasing estimated glomerular filtration rate (eGFR) reaching a trough of 115 ml/min per 1.73 m(2). Using these values as cutoff points, patients with systolic blood pressureor =135 mmHg and eGFR115 ml/min per 1.73 m(2) had 2-fold increased risk of IS.In type 2 diabetic patients, body mass index, hemoglobin, systolic blood pressure and eGFR exhibit different risk relationships and thresholds for IS contingent upon presence or absence of albuminuria. |
| Databáze: | OpenAIRE |
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