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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Prediction of Persistent Impaired Glucose Tolerance in Patients with Minor Ischemic Stroke or Transient Ischemic Attack
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Prediction of Persistent Impaired Glucose Tolerance in Patients with Minor Ischemic Stroke or Transient Ischemic Attack

机译：患有轻微缺血性卒中或短暂性缺血症患者患者持续存在的葡萄糖耐量的预测

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Background: Impaired glucose tolerance (IGT) in patients with ischemic stroke can return to normal, reflecting an acute stress response, or persist. Persistent IGT is associated with an increased risk of recurrent stroke, other cardiovascular diseases and unfavorable outcome after stroke. We aim to validate our previously developed model to identify patients at risk of persistent IGT in an independent data set, and, if necessary, update the model. Methods: The validation data set consisted of 239 nondiabetic patients with a minor ischemic stroke or TIA and IGT in the acute phase (2-hour post-load glucose levels between 7.8 and 11.0 mmol/l). The outcome was persistent versus normalized IGT, based on repeated oral glucose tolerance test after a median of 46 days. The discriminative ability of the original model was assessed with the area under the ROC curve (AUC). The updated model was internally validated with bootstrap resampling and cross-validated in the development population of the original model. Results: One-hundred eighteen of 239 (49%) patients had persistent IGT. The original model, with the predictors age, current smoking, statin use, triglyceride, hypertension, history of cardiovascular diseases, body mass index (BMI), fasting plasma glucose performed poorly (AUC.60). The newly developed model included only BMI, hypertension, statin use, atrial fibrillation, 2-hour post-load glucose levels, HbA1c, large artery atherosclerosis, and predicted persistent IGT more accurately (internally validated AUC 0.66, externally validated AUC.71). Conclusions: This prediction model with simple clinical variables can be used to predict persistent IGT in patients with IGT directly after minor stroke or TIA, and may be useful to optimize secondary prevention by early identification of patients with disturbed glucose metabolism.
机译：背景：缺血性中风患者的糖耐量受损（IGT）可以恢复正常，反映急性应激反应，或持续存在。持续性IGT与卒中复发、其他心血管疾病和卒中后不良结局的风险增加有关。我们的目标是验证我们先前开发的模型，以在独立数据集中识别有持续性IGT风险的患者，并在必要时更新模型。方法：验证数据集包括239名急性期（负荷后2小时血糖水平在7.8至11.0 mmol/l之间）患有轻微缺血性卒中或TIA和IGT的非糖尿病患者。根据中位数为46天后的反复口服糖耐量试验，结果为持续性IGT与标准化IGT。用ROC曲线下面积（AUC）评估原始模型的辨别能力。更新后的模型通过自举重采样进行内部验证，并在原始模型的开发群体中进行交叉验证。结果：239例患者中118例（49%）患有持续性IGT。原始模型的预测因子包括年龄、当前吸烟、他汀类药物使用、甘油三酯、高血压、心血管疾病史、体重指数（BMI）、空腹血糖（AUC.60）。新开发的模型仅包括BMI、高血压、他汀类药物使用、心房颤动、2小时负荷后血糖水平、HbA1c、大动脉动脉粥样硬化，并更准确地预测持续性IGT（内部验证AUC 0.66，外部验证AUC.71）。结论：该预测模型具有简单的临床变量，可用于预测轻度脑卒中或短暂性脑缺血发作（TIA）后IGT患者的持续性IGT，并可能有助于通过早期识别糖代谢紊乱患者来优化二级预防。

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