Microembolic Signals is Associated With Insulin Resistance Among Acute Ischemic Stroke Patients

• Published in: Journal of stroke and cerebrovascular diseases Vol. 28; no. 4; pp. 1070 - 1077
• Main Authors: Zhou, Xuyou, Zhang, Dongmei, Zhou, Yong, Wang, Fang, Zhu, Xiangyang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2019
• Subjects: Aged; Aged, 80 and over; Biomarkers - blood; Blood Glucose - metabolism; Brain Ischemia - blood; Brain Ischemia - diagnostic imaging; Brain Ischemia - etiology; Female; Humans; Insulin - blood; Insulin Resistance; Intracranial Embolism - blood; Intracranial Embolism - diagnostic imaging; Intracranial Embolism - etiology; ischemic stroke; Male; microembolic signal; Middle Aged; middle cerebral artery; Risk Factors; Stroke - blood; Stroke - diagnostic imaging; Stroke - etiology; Time Factors; transcranial doppler sonography; Ultrasonography, Doppler, Transcranial; NIHSS; OR; LDL-C; microembolic signal; CI; FINS; IR; IQR; AIS; middle cerebral artery; Lp-PLA2; TC; SD; HOMA-IR; TG; TCD; hsCRP; Insulin resistance; MES; FPG; HbA1c; ischemic stroke; transcranial doppler sonography; HCY
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2018.12.033

Microembolic signals (MES) and insulin resistance (IR) is common in patients with acute ischemic stroke (AIS). Patients with active MES tend to be more seriously ill and prone to aggravating disease progression. IR is an important risk factor for stroke which has been found to be associated with the severity of stroke. This study aims to investigate the clinical correlation between intracranial MES and IR in AIS patients. A total of 119 patients with AIS were enrolled in this study. The IR index (HOMA-IR) was calculated according to the homeostasis model and divided into 4 levels, where IR was defined by HOMA-IR index in the top quartile (Q4). Transcranial Doppler Sonography was performed in all patients within 72 hours after the stroke onset to monitor arterial MES in the lesion side of the brain for 30 minutes. It is found that the positive rate of MES increased with the increase of IR level. The positive rate of MES in IR group was 55.2% (16/29), and that in non-IR group was 32.2% (29/90). In addition, HOMA-IR in patients with MES− were significantly lower than those in patients with MES+ (1.6 [Interquartile range: 0.9-2.5] compared with 2.2 [Interquartile range: 1.3-4.1], P < .05).In multiple logistic regression analysis, we calculated the OR of MES as compared with the HOMA-IR. The result of OR value is 1.38 (95% confidence interval: 1.05-1.82, P = .02). IR is positively related to MES in patients with AIS. Higher level of IR might contribute to plaque destabilization and the formation of MES, which finally leading to the occurrence of stroke.