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Fasting and post-glucose load measures of insulin resistance and risk of ischemic stroke in older adults.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Fasting and post-glucose load measures of insulin resistance and risk of ischemic stroke in older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Thacker, EL, Psaty, BM, McKnight, B, Heckbert, SR, Longstreth, WT, Mukamal, KJ, Meigs, JB, de Boer, IH, Boyko, EJ, Carnethon, MR, Kizer, JR, Tracy, RP, Smith, NL, Siscovick, DS |
| Journal | Stroke |
| Volume | 42 |
| Issue | 12 |
| Pagination | 3347-51 |
| Date Published | 2011 Dec |
| ISSN | 1524-4628 |
| Keywords | Aged, Aged, 80 and over, Blood Glucose, Body Mass Index, Brain Ischemia, Fasting, Female, Humans, Incidence, Insulin Resistance, Male, Risk, Stroke |
| Abstract | <p><b>BACKGROUND AND PURPOSE: </b>Few studies have assessed post-glucose load measures of insulin resistance and ischemic stroke risk, and data are sparse for older adults. We investigated whether fasting and post-glucose load measures of insulin resistance were related to incident ischemic stroke in nondiabetic, older adults.</p><p><b>METHODS: </b>Participants were men and women in the Cardiovascular Health Study, age 65+ years and without prevalent diabetes or stroke at baseline, followed for 17 years for incident ischemic stroke. The Gutt insulin sensitivity index was calculated from baseline body weight and from fasting and 2-hour postload insulin and glucose; a lower Gutt index indicates higher insulin resistance.</p><p><b>RESULTS: </b>Analyses included 3442 participants (42% men) with a mean age of 73 years. Incidence of ischemic stroke was 9.8 strokes per 1000 person-years. The relative risk (RR) for lowest quartile versus highest quartile of Gutt index was 1.64 (95% CI, 1.24-2.16), adjusted for demographics and prevalent cardiovascular and kidney disease. Similarly, the adjusted RR for highest quartile versus lowest quartile of 2-hour glucose was 1.84 (95% CI, 1.39-2.42). In contrast, the adjusted RR for highest quartile versus lowest quartile of fasting insulin was 1.10 (95% CI, 0.84-1.46).</p><p><b>CONCLUSIONS: </b>In nondiabetic, older adults, insulin resistance measured by Gutt index or 2-hour glucose, but not by fasting insulin, was associated with risk of incident ischemic stroke.</p> |
| DOI | 10.1161/STROKEAHA.111.620773 |
| Alternate Journal | Stroke |
| PubMed ID | 21998054 |
| PubMed Central ID | PMC3226936 |
| Grant List | T32 HL007902 / HL / NHLBI NIH HHS / United States R01 HL094555-04 / HL / NHLBI NIH HHS / United States N01 HC085086 / HC / NHLBI NIH HHS / United States T32 HL007902-09 / HL / NHLBI NIH HHS / United States R01 AG015928-02 / AG / NIA NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States K24 DK080140-05 / DK / NIDDK NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States R01 AG027058-04 / AG / NIA NIH HHS / United States R56 AG020098 / AG / NIA NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States R01 HL080295-07 / HL / NHLBI NIH HHS / United States R01 AG023629-06 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States R01 HL094555 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States K24-DK080140 / DK / NIDDK NIH HHS / United States T32-HL007902 / HL / NHLBI NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States K24 DK080140 / DK / NIDDK NIH HHS / United States P30 DK017047-30 / DK / NIDDK NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01 AG020098-09 / AG / NIA NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States HL-080295 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States HL-094555 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States P30-DK17047 / DK / NIDDK NIH HHS / United States P30 DK017047 / DK / NIDDK NIH HHS / United States |