Impaired glucose tolerance and insulin resistance in patients with stroke

Background : The purpose of this study was to assess the prevalence of impaired glucose tolerance (IGT) and insulin resistance in stroke patients without previously known diabetes by performing a 75g oral glucose tolerance test (75g OGTT).Methods : We recruited 203 stroke patients (atherothrombotic infarction (ATI) ; 42.2%, lacunar infarction (LI) ; 29.6%, cardioembolic infarction (CE) ; 11.3%, cerebral hemorrhage (Hem) ; 11.8%, transient ischemic attack ; 3.9%, others; 1.2%). 75g OGTT was used to evaluate the disorders of glucose metabolism. We investi-gated the relationships between the incidence of IGT and insulin resistance using HOMA-R and stroke sub-types.Results : The disorders of glucose metabolism were present in 62.7% of patients without previously known diabetes. Diabetes and IGT were diagnosed in 38% and 28%, respectively, of patient with ATI. IGT was observed 35% with a single risk factor (hypertension or hyperlipidemia) and 65% with two risk factors (both of hypertension and hyperlipidemia). HOMA-R was markedly higher level in patients with ATI than with another stoke subtypes.Conclusions : A screening by 75g OGTT was useful for diagnosis of the disorders of glucose metabolism in patients with no prior history of diabetes. Insulin resistance might be an important role for the progression of atherosclerosis in patients with ATI.