Insulin resistance in ischemic stroke

Deng, Xiaoling; Liu, Zhou; Wang, Chuanling; Li, Yanfeng; Zhang, Cai

doi:10.1007/s11011-017-0050-0

Cited by 55 publications

(42 citation statements)

References 165 publications

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“…Vegetarian and especially vegan dietary patterns improve both fasting and postprandial blood lipids compared with conventional therapeutic diets [ 18 , 86 , 87 , 88 , 89 , 90 , 91 ], with effects similar to those seen with statin therapy [ 92 ]. If combined with moderate physical exercise, smoking cessation and stress management, the reduction of blood lipids can be even higher [ 10 ].…”

Section: Plant-based Diets and Blood Lipidsmentioning

confidence: 99%

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Cardio-Metabolic Benefits of Plant-Based Diets

2017

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Cardio-metabolic disease, namely ischemic heart disease, stroke, obesity, and type 2 diabetes, represent substantial health and economic burdens. Almost one half of cardio-metabolic deaths in the U.S. might be prevented through proper nutrition. Plant-based (vegetarian and vegan) diets are an effective strategy for improving nutrient intake. At the same time, they are associated with decreased all-cause mortality and decreased risk of obesity, type 2 diabetes, and coronary heart disease. Evidence suggests that plant-based diets may reduce the risk of coronary heart disease events by an estimated 40% and the risk of cerebral vascular disease events by 29%. These diets also reduce the risk of developing metabolic syndrome and type 2 diabetes by about one half. Properly planned vegetarian diets are healthful, effective for weight and glycemic control, and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. The use of plant-based diets as a means of prevention and treatment of cardio-metabolic disease should be promoted through dietary guidelines and recommendations.

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Section: Plant-based Diets and Blood Lipidsmentioning

confidence: 99%

“…In addition, insulin resistance plays a role in the pathogenesis of ischemic stroke by encouraging atherosclerotic changes. Clinical studies have suggested that improving insulin resistance may be an effective way how to prevent or delay ischemic stroke [ 88 ].…”

Section: Plant-based Diets and Platelet Aggregationmentioning

confidence: 99%

Cardio-Metabolic Benefits of Plant-Based Diets

2017

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“…Stroke is one of the most common causes of death and disability worldwide, and risk factor modification is crucial for the prevention of ischemic stroke (IS). Among the well-established modifiable risk factors, diabetes mellitus (DM) and insulin resistance (IR) are independent risk factors for worse clinical outcomes of acute IS [1,2], and long-term stroke recurrence [3]. IR may promote platelet aggregation, accelerate atherosclerosis, impair cerebrovascular reserve function, and cause endothelial dysfunction [3].…”

Section: Introductionmentioning

confidence: 99%

“…Among the well-established modifiable risk factors, diabetes mellitus (DM) and insulin resistance (IR) are independent risk factors for worse clinical outcomes of acute IS [1,2], and long-term stroke recurrence [3]. IR may promote platelet aggregation, accelerate atherosclerosis, impair cerebrovascular reserve function, and cause endothelial dysfunction [3]. Therefore, patients with IR often have higher incidence rates of vascular events, including recurrent IS [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…IR may promote platelet aggregation, accelerate atherosclerosis, impair cerebrovascular reserve function, and cause endothelial dysfunction [3]. Therefore, patients with IR often have higher incidence rates of vascular events, including recurrent IS [3,4]. Peroxisome proliferator-activated receptor-γ (PPAR-γ) is a known essential mediator for the maintenance of whole body insulin sensitivity [5].…”

Section: Introductionmentioning

confidence: 99%

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Pioglitazone and PPAR-γ modulating treatment in hypertensive and type 2 diabetic patients after ischemic stroke: a national cohort study

Liu

Lee

Lin

et al. 2020

Cardiovasc Diabetol

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Background and aim: Peroxisome proliferator-activated receptor-γ (PPAR-γ) modulating treatment may have cardiovascular benefits in type 2 diabetes mellitus (T2DM) patients after ischemic stroke (IS). However, whether there are additional benefits from intensive PPAR-γ modulating treatments in Asian patients with T2DM and hypertension (HTN) after IS remains unknown.Methods: Between 2001 and 2013, patients admitted due to IS were identified from the National Health Insurance Research Database of Taiwan. Patients with T2DM and HTN using angiotensin receptor blockers were further included. Eligible patients were divided into two groups: (1) pioglitazone and (2) non-pioglitazone oral anti-diabetic agent groups. Propensity score matching (1:2) was used to balance the distribution of baseline characteristics, stroke severity and medications. The primary outcome was recurrent IS. Subgroup analysis for recurrent IS in pioglitazone and/or telmisartan users, the trend of IS risks across different PPAR-γ intensity treatments, and dose-dependent outcomes across different pioglitazone possession ratios were further studied. Statistical significance was set at p < 0.05 and p < 0.1 for clinical outcomes and interaction of subgroup analyses, respectively.Results: There were 3190 and 32,645 patients in the pioglitazone and non-pioglitazone groups. Patients of the pioglitazone group had a lower risk of recurrent IS (subdistribution hazard ratio, 0.91; 95% confidence interval 0.84-0.99). Pioglitazone was also associated with reduced recurrent IS in patients who also used telmisartan (p for interaction = 0.071). A graded correlation was found a borderline significant trend between the intensity of PPAR-γ therapy and following IS (p = 0.076). The dose-dependent outcome also showed that a borderline significant trend that higher pioglitazone possession ratio was associated with a lower risk of recurrent IS (p = 0.068). Conclusions:The current study suggests that the use of pioglitazone in type 2 diabetic and hypertensive IS patients is associated with fewer recurrent IS events in an Asian population. Concurrent telmisartan use or a higher pioglitazone possession ratio may have a trend of increased pleiotropic effects, which could possibly be related to higher PPAR-γ effects. Future studies are warranted to confirm or refute the clinical effects and the possible mechanism of more intensive PPAR-γ-modulating treatments. © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article' s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article'

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Comparison of six surrogate insulin resistance indexes for predicting the risk of incident stroke: The Rural Chinese Cohort Study

Zhao

Zhang

Chen

et al. 2022

Diabetes Metabolism Res

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Background and Purpose: Some cheap and easily used operated indexes of insulin resistance (IR) were currently available. We aimed to evaluate the association of six surrogate indexes of IR with incident stroke and to compare their predictive capacity. Methods:We analysed data from 14,595 eligible study participants from the Rural Chinese Cohort Study. Modified Poisson regression models were used to estimate relative risks (RRs) and 95% confidence intervals (95% CIs) of incident stroke associated with the visceral adiposity index (VAI), the Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), triglyceride-glucose (TyG), TyGbody mass index, and TyG-waist circumference. The receiver operator characteristic curve was used to compare the ability of the abovementioned IR indexes to predict stroke.Results: During a median follow-up of 6 years, 786 newly diagnosed stroke cases were identified. The levels of six surrogate indexes of IR were all significantly higher in the stroke population than in the non-stroke population (p < 0.001). Compared with quartile 1, the multivariable adjusted RRs (95% CIs) of incident stroke for quartile 4 were 2.01 (1.47-2.76), 1.62 (1.28, 2.04), 1.64 (1.28-2.09), and 1.92 (1.50-2.45) for CVAI, VAI, LAP, and TyG, respectively. Significant dose-response associations were also found between surrogate IR indexes and risk of stroke. The area under the curves|areas under the curves for CVAI (0.674) was significantly greater than for other indexes (TyG-WC:0.622, TyG:0.614, LAP:0.606, TyG-BMI:0.598, and VAI:0.577) (p < 0.001).Conclusions: Six surrogate indexes of IR were independently associated with incident stroke. The CVAI may be the most suitable index for stroke prediction.

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Insulin resistance in ischemic stroke

Cited by 55 publications

References 165 publications

Cardio-Metabolic Benefits of Plant-Based Diets

Cardio-Metabolic Benefits of Plant-Based Diets

Pioglitazone and PPAR-γ modulating treatment in hypertensive and type 2 diabetic patients after ischemic stroke: a national cohort study

Comparison of six surrogate insulin resistance indexes for predicting the risk of incident stroke: The Rural Chinese Cohort Study

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