Blood sugar and stroke

[Guest guest]

Hi All,

Glycemia, as indicated by haemoglobin A1c, which indicates our exposure levels

of

blood glucose longer term " Because the glucose stays attached for the life of

the

cell (about 4 months), a test to measure haemoglobin A1C shows what the person's

average blood glucose level was for that period of time " , seems to be a risk

factor

for stroke, as it is for heart disease. Those who were followed and had no

diabetes

would be more of interest to us general, as CRers. We CRers have lower body

mass

indices, but this was not related to stroke risk. The waist to hip ratio was

related to stroke risk. Systolic and diastolic blood pressure may be more

relevant

to those without diabetes also, as was the HDL versus LDL. It being a

prospective

study was good.

See the pdf-available below paper.

Selvin E, Coresh J, Shahar E, Zhang L, Steffes M, Sharrett AR.

Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis

Risk

in Communities (ARIC) Study.

Lancet Neurol. 2005 Dec;4(12):821-6.

PMID: 16297840

BACKGROUND: Individuals with diabetes have a raised risk of stroke, but it is

unclear whether sustained hyperglycaemia contributes to the development of

cerebrovascular disease. Haemoglobin A1c (HbA(1c)), a measure of long-term

glycaemia, is strongly related to retinopathy, nephropathy, and neuropathy in

diabetes. We sought to assess the association between HbA(1c) and stroke in

people

with and without diabetes.

METHODS: 10,886 participants without diabetes and 1635 participants with

diabetes in

the ARIC study, who did not have cardiovascular disease, were followed up for

incident ischaemic stroke over 8-10 years. We assayed HbA(1c) for all 167 stroke

cases and a sample of 680 non-cases in the adults without diabetes and for the

full

cohort of 1635 adults with diabetes (including 89 stroke cases). ...

FINDINGS: The adjusted relative risks of stroke increased with increasing

tertile of

HbA1c in both adults without diabetes (p=0.02) and with diabetes (p<0.0001).

Compared with adults without diabetes in the lowest tertile of HbA1c, the

adjusted

relative risks of stroke by HbA(1c) tertile were 1.18 (0.70-2.00) and 1.58

(0.94-2.66) in adults without diabetes and 1.75 (0.90-3.42), 2.29 (1.24-4.21),

and

4.71 (2.69-8.25) in adults with diabetes.

INTERPRETATION: Raised HbA(1c) could be an independent risk factor for stroke in

people with and without diabetes, with relative risks similar to those

previously

reported for coronary heart disease.

.... people aged 45–64 years at baseline

Table. Adjusted* baseline characteristics of ischaemic stroke cases and

non-cases in

adults with and without diabetes

==========================================

No diabetes** Diabetes

No stroke (n=680) Stroke (n=167) p No stroke (n=1546) Stroke (n=89) p

==========================================

HbA1c, % 4·8 4·9 0·030 6·7 7·6 <0·0001

Fasting glucose, mmol/L 5·56 5·61 0·590 9·24 10·45 0·001

Systolic blood pressure, mm Hg 120 128 <0·0001 128 132 0·022

Diastolic blood pressure, mm Hg 72·2 75·0 0·007 73·2 73·9 0·466

LDL cholesterol, mmol/L 3·36 3·41 0·578 3·49 3·69 0·041

HDL cholesterol, mmol/L 1·34 1·24 0·004 1·15 1·09 0·062

Body-mass index, kg/m2 27·6 27·3 0·449 31·0 31·6 0·339

Waist-to-hip ratio 0·91 0·93 <0·0001 0·96 0·98 0·016

Current smokers,% 19·8 34·0 <0·0001 18·6 32·2 0·001

Patients taking hypertension medication,% 28·0 50·2 <0·0001 44·3 51·3 0·176

Patients with <12 years of education 16·2 29·4 0·001 28·8 38·3 0·043

==========================================

* Adjusted for age, sex, and ethnic origin by the least squares method

** Adjusted means and proportions in individuals without diabetes are weighted

to

account for the case-cohort sampling design.

Al Pater, PhD; email: old542000@...

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