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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Impaired glucose tolerance increases stroke risk in nondiabetic patients with transient ischemic attack or minor ischemic stroke.
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Impaired glucose tolerance increases stroke risk in nondiabetic patients with transient ischemic attack or minor ischemic stroke.

机译：糖耐量降低会增加患有短暂性脑缺血发作或轻度缺血性脑卒中的非糖尿病患者的中风风险。

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BACKGROUND AND PURPOSE: Impaired glucose tolerance, an intermediate metabolic state between normal glucose and diabetes characterized by nonfasting glucose levels between 7.8 to 11.0 mmol/L, is associated with an increased stroke risk in patients with coronary heart disease. Whether impaired glucose tolerance increases the risk of stroke in patients with transient ischemic attack (TIA) or minor ischemic stroke is unknown. METHODS: In total, 3127 patients with a TIA or minor ischemic stroke participated in the Dutch TIA Trial, testing 2 different doses of aspirin and atenolol versus placebo. We estimated the risk of stroke and the risk of myocardial infarction or cardiac death in relation to baseline nonfasting glucose levels (mean 6.0, SD 2.2 mmol/L) with Cox proportional hazards regression analysis, adjusted for cardiovascular risk factors. RESULTS: During 2.6 years follow-up, 272 patients (9%) experienced a stroke and 200 (6%) a myocardial infarction or cardiac death. We found a J-shaped relationshipbetween baseline nonfasting glucose levels and stroke risk. Stroke risk was nearly doubled in patients with impaired glucose tolerance (glucose 7.8 to 11.0 mmol/L) compared with those with normal glucose levels (hazard ratio [HR] 1.8, 95% CI, 1.1 to 3.0) and nearly tripled in diabetic patients (glucose > or =11.1 mmol/L; HR 2.8, 95% CI, 1.9 to 4.1). Patients with low glucose levels (<4.6 mmol/L) had a 50% increased stroke risk (HR 1.5, 95% CI, 1.0 to 2.2) compared with those with normal glucose levels. There was no association between glucose levels and risk of myocardial infarction or cardiac death. CONCLUSIONS: Impaired glucose tolerance is an independent risk factor for future stroke in nondiabetic patients with TIA or minor ischemic stroke.
机译：背景与目的：糖耐量降低是正常葡萄糖与糖尿病之间的一种中间代谢状态，其特征是空腹血糖水平在7.8至11.0 mmol / L之间，与冠心病患者的中风风险增加有关。糖耐量降低是否会增加短暂性脑缺血发作（TIA）或轻度缺血性脑卒中患者的中风风险尚不清楚。方法：共有3127例TIA或轻度缺血性中风患者参加了荷兰TIA试验，测试了2种不同剂量的阿司匹林和阿替洛尔与安慰剂的比较。我们通过校正心血管风险因素的Cox比例风险回归分析，估计了与基线非禁食血糖水平（平均值6.0，SD 2.2 mmol / L）相关的中风风险和心肌梗塞或心脏死亡的风险。结果：在2.6年的随访中，有272例患者（9％）发生了中风，200例患者（6％）发生了心肌梗塞或心源性死亡。我们发现基线非空腹血糖水平与中风风险之间呈J型关系。与正常葡萄糖水平（危险比[HR] 1.8，95％CI，1.1-3.0）相比，葡萄糖耐量下降（葡萄糖7.8至11.0 mmol / L）患者的中风风险几乎增加了一倍，而糖尿病患者则达到三倍（葡萄糖>或= 11.1 mmol / L; HR 2.8，95％CI，1.9至4.1）。与正常血糖水平相比，低血糖水平（<4.6 mmol / L）患者的中风风险增加50％（HR 1.5、95％CI，1.0至2.2）。血糖水平与心肌梗塞或心源性死亡风险之间没有关联。结论：糖耐量下降是非糖尿病性TIA或轻度缺血性卒中患者未来卒中的独立危险因素。

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