Association between impaired insulin sensitivity and stroke

Dawn Bravata, Carolyn K. Wells, Walter N. Kernan, John Concato, Lawrence M. Brass, Barbara I. Gulanski

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Prior research has indicated an association between insulin resistance and stroke; we sought to determine if this association persists after adjusting for stroke risk factors, including glycemic control. Methods: We used data from the Third National Health and Nutrition Survey (1988-1994), including participants aged ≥40 years. We assessed insulin sensitivity using the homeostasis model assessment (HOMA): HOMA = (FPGSI x FPI)/22.5, where FPGSI refers to fasting plasma glucose (mmol/l) and FPI refers to fasting plasma insulin (μU/l). Increasing HOMA indicates decreasing insulin sensitivity. We used glycosylated hemoglobin (HbA1c) to measure glycemic control. Multivariable logistic regression analysis was used to identify factors that were independently associated with stroke. Results: Among 3,844 participants, 168 (4%) reported a stroke history. Participants with stroke had lower insulin sensitivity than participants without stroke: HOMA mean ± standard deviation, 4.0 ± 4.0 vs. 3.3 ± 3.0; p = 0.022. HOMA was independently associated with stroke (odds ratio 1.06, 95% CI: 1.01-1.12; adjusted for age, hypertension, myocardial infarction, claudication, activity, and HbA1c). The strength of the association between HOMA and stroke was similar to the association between claudication and stroke (index R 2: 0.0032 vs. 0.0036). Conclusions: Impaired insulin sensitivity is independently associated with stroke, even after adjustment for glycemic control.

Original languageEnglish (US)
Pages (from-to)69-74
Number of pages6
JournalNeuroepidemiology
Volume25
Issue number2
DOIs
StatePublished - 2005
Externally publishedYes

Fingerprint

Insulin Resistance
Stroke
Homeostasis
Fasting
Nutrition Surveys
Glycosylated Hemoglobin A
Health Surveys
Logistic Models
Odds Ratio
Myocardial Infarction
Regression Analysis
Insulin
Hypertension
Glucose
Research

Keywords

  • Brain infarction
  • Brain ischemia
  • Insulin resistance

ASJC Scopus subject areas

  • Epidemiology
  • Clinical Neurology

Cite this

Bravata, D., Wells, C. K., Kernan, W. N., Concato, J., Brass, L. M., & Gulanski, B. I. (2005). Association between impaired insulin sensitivity and stroke. Neuroepidemiology, 25(2), 69-74. https://doi.org/10.1159/000086286

Association between impaired insulin sensitivity and stroke. / Bravata, Dawn; Wells, Carolyn K.; Kernan, Walter N.; Concato, John; Brass, Lawrence M.; Gulanski, Barbara I.

In: Neuroepidemiology, Vol. 25, No. 2, 2005, p. 69-74.

Research output: Contribution to journalArticle

Bravata, D, Wells, CK, Kernan, WN, Concato, J, Brass, LM & Gulanski, BI 2005, 'Association between impaired insulin sensitivity and stroke', Neuroepidemiology, vol. 25, no. 2, pp. 69-74. https://doi.org/10.1159/000086286
Bravata D, Wells CK, Kernan WN, Concato J, Brass LM, Gulanski BI. Association between impaired insulin sensitivity and stroke. Neuroepidemiology. 2005;25(2):69-74. https://doi.org/10.1159/000086286
Bravata, Dawn ; Wells, Carolyn K. ; Kernan, Walter N. ; Concato, John ; Brass, Lawrence M. ; Gulanski, Barbara I. / Association between impaired insulin sensitivity and stroke. In: Neuroepidemiology. 2005 ; Vol. 25, No. 2. pp. 69-74.
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