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Pancreatic β-Cell Function and Prognosis of Nondiabetic Patients With Ischemic Stroke.

Pancreatic β-Cell Function and Prognosis of Nondiabetic Patients With Ischemic Stroke.
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Pan Y, Chen W, Jing J, Zheng H, Jia Q, Li H, Zhao X, Liu L, Wang Y, He Y, Wang Y,


Pan Y, Chen W, Jing J, Zheng H, Jia Q, Li H, Zhao X, Liu L, Wang Y, He Y, Wang Y, (click to view)

Pan Y, Chen W, Jing J, Zheng H, Jia Q, Li H, Zhao X, Liu L, Wang Y, He Y, Wang Y,

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Stroke 2017 09 27() pii STROKEAHA.117.018203
Abstract
BACKGROUND AND PURPOSE
Pancreatic β-cell dysfunction is an important factor in the development of type 2 diabetes mellitus. This study aimed to estimate the association between β-cell dysfunction and prognosis of nondiabetic patients with ischemic stroke.

METHODS
Patients with ischemic stroke without a history of diabetes mellitus in the ACROSS-China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry were included. Disposition index was estimated as computer-based model of homeostatic model assessment 2-β%/homeostatic model assessment 2-insulin resistance based on fasting C-peptide level. Outcomes included stroke recurrence, all-cause death, and dependency (modified Rankin Scale, 3-5) at 12 months after onset.

RESULTS
Among 1171 patients, 37.2% were women with a mean age of 62.4 years. At 12 months, 167 (14.8%) patients had recurrent stroke, 110 (9.4%) died, and 184 (16.0%) had a dependency. The first quartile of the disposition index was associated with an increased risk of stroke recurrence (adjusted hazard ratio, 3.57; 95% confidence interval, 2.13-5.99) and dependency (adjusted hazard ratio, 2.30; 95% confidence interval, 1.21-4.38); both the first and second quartiles of the disposition index were associated with an increased risk of death (adjusted hazard ratio, 5.09; 95% confidence interval, 2.51-10.33; adjusted hazard ratio, 2.42; 95% confidence interval, 1.17-5.03) compared with the fourth quartile. Using a multivariable regression model with restricted cubic spline, we observed an L-shaped association between the disposition index and the risk of each end point.

CONCLUSIONS
In this large-scale registry, β-cell dysfunction was associated with an increased risk of 12-month poor prognosis in nondiabetic patients with ischemic stroke.

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