Stroke: After an acute stroke, how does pancreatic islet B cell function affect the prognosis?

Every year, more than 14 million people worldwide experience ischemic stroke
.

Since the current global focus is to improve the prognosis of patients with ischemic stroke, it is necessary to clarify the pathophysiological factors that are not conducive to clinical outcomes

Stroke

It is well known that deterioration of β-cell function and insulin resistance are the main pathophysiological factors of type 2 diabetes
.

It has been reported not only insulin resistance and diabetes, but also with non-diabetic patients with heart vascular related diseases

Diabetes, heart blood vessels

However, there is little evidence on the association between β-cell function and clinical outcomes after ischemic stroke
.

Only the Chinese research team has shown that in non-diabetic patients with ischemic stroke, decreased β-cell function is associated with a higher risk of poor long-term clinical outcomes.

The secretion of insulin is affected by insulin resistance
.

This fact indicates that insulin resistance may change the relationship between β-cell function and clinical prognosis after ischemic stroke, but so far few clinical studies have studied this issue

In this way, Takuya Kiyohara and others of Kyushu University, Kyushu University, Japan, based on the prospective research of the hospital, explored the relationship between β-cell function and short-term clinical prognosis in non-diabetic patients after acute ischemic stroke
.

They followed 3590 non-diabetic patients with acute ischemic stroke (average age 71 years) for 3 months
.

The evaluation of β cell function adopts the equilibrium model assessment of β cell function (HOMA-β)

The results of the study were mRS (3-6 points) and stroke recurrence 3 months after the onset of stroke, as well as neurological deterioration at discharge (NIHSS≥2 points)
.

Finally, logistic regression analysis was used to evaluate the association between serum HOMA-β quintile levels and clinical results

They found that with the decline in HOMA-β levels, the age- and gender-adjusted odds of dysfunction and neurological deterioration increased significantly
.

The age- and gender-adjusted odds of dysfunction and neurological deterioration increase significantly
.

After adjusting for HOMA-insulin resistance, these associations became more prominent, even if other confounding factors were further adjusted, namely, body mass index, dyslipidemia, high blood pressure, estimated glomerular filtration rate, stroke subtype, and U.

S.
National at admission After the Institute of Health Stroke Scale score and reperfusion therapy, these associations remained basically unchanged

No such association was observed in stroke recurrence
.

In a stratified analysis of the combination of HOMA-β and HOMA-insulin resistance levels, lower HOMA-β and higher HOMA-insulin resistance levels were independently associated with dysfunctional outcomes and increased risk of neurological deterioration
.

The results of the study showed that in patients with non-diabetic acute ischemic stroke, β-cell dysfunction was significantly related to short-term adverse clinical outcomes, and was not related to insulin resistance
.

In non-diabetic patients with acute ischemic stroke, β-cell dysfunction is significantly related to short-term adverse clinical outcomes, and has nothing to do with insulin resistance
.

Original source:

Kiyohara T, Matsuo R, Hata J, et al.
β-Cell Function and Clinical Outcome in Nondiabetic Patients With Acute Ischemic Stroke.
Stroke.
2021;52(8):2621-2628.
doi:10.
1161/STROKEAHA.
120.
031392

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