Hyperglycemia and incidence of ischemic and hemorrhagic stroke-comparison between fasting and 2-hour glucose criteria
2009 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 40, no 5, 1633-1637 p.Article in journal (Refereed) Published
BACKGROUND AND PURPOSE: We examined the impact of hyperglycemia on ischemic and hemorrhagic stroke incidence comparing criteria based on fasting plasma glucose (FPG) and 2-hour plasma glucose (2-hour PG). METHODS: Data from 9 European cohorts comprising 18 360 individuals between 25 to 90 years of age were collaboratively analyzed. The maximum length of follow-up varied between 4.9 to 36.8 years. Hazards ratios (95% confidence intervals) for stroke incidence were estimated using Cox-proportional hazards model adjusting for known risk factors. RESULTS: In individuals without a prior history of diabetes, the multivariate-adjusted hazards ratio for ischemic stroke corresponding to 1 SD increase in FPG was 1.12 (1.02 to 1.22) and in 2-hour PG 1.14 (1.05 to 1.24). Adding 2-hour PG to the model with FPG significantly improved the prediction of the model for the incidence of ischemic stroke (chi(2)=4.72, P=0.03), whereas FPG did not improve the 2-hour PG model prediction (chi(2)=0.25, P=0.62). A significantly increased hazard ratio was also observed for previously diagnosed diabetes (2.26 [1.51 to 3.38]) and for screen-detected diabetes defined by FPG (1.48 [1.08 to 2.02]) and 2-hour PG (1.60 [1.18 to 2.16]). None of the criteria predicted hemorrhagic stroke. CONCLUSIONS: Diabetes defined by either of the criteria predicted the future risk of ischemic stroke but not the hemorrhagic stroke. The prediction is stronger for elevated 2-hour PG than for FPG levels.
Place, publisher, year, edition, pages
2009. Vol. 40, no 5, 1633-1637 p.
fasting plasma glucose, 2-h plasma glucose, ischemic stroke, hemorrhagic stroke, incidence
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-102735DOI: 10.1161/STROKEAHA.108.539650ISI: 000265579800017PubMedID: 19286584OAI: oai:DiVA.org:uu-102735DiVA: diva2:216654
Group Author(s): DECODE Study Group2009-05-112009-05-112010-10-19Bibliographically approved