Correlation between acute stress hyperglycemia and hemoglobin A1c in patients with cerebral infarction / 中华老年医学杂志

ABSTRACT

Objective:To investigate whether the basal blood glucose level before cerebral infarction has an impact on acute stress hyperglycemia.Methods:A total of 366 patients with cerebral infarction admitted into the neurology department of our hospital from February 2008 to May 2012 were enrolled in this study. Acute stress hyperglycemia was reflected by stress-induced glucose up-regulation ratio (SIGUR), and the basal glucose before cerebral infarction was reflected by glycosylated hemoglobin A1c (HbA1c). The correlation between SIGUR and HbA1c was analyzed in the different populations. The difference in SIGUR was compared among the non-diabetic group, diabetes with poor blood glucose control group (HbA1≥6.5%) and diabetes with well blood glucose control group (HbA1c<6.5%). The relationship between high level of SIGUR (Q4) and HbA1c was performed through logistic regression analysis.Results:SIGUR was correlated with HbA1c, no matter in the non-diabetic, diabetic or total populations ( r=-0.200, 0.195 and 0.324, P=0.010, 0.011 and 0.000). The level of SIGUR was higher in diabetes with poor blood glucose control group than in the non-diabetes and diabetes with well blood glucose control group ( F=25.842, P=0.000), but there was no significant difference between the non-diabetic group and diabetes with well blood glucose control group ( P>0.05). Logistic regression analysis showed that the high level of SIGUR was correlated to HbA1c in the total populations ( OR=1.460, P=0.000). In the diabetic group, the probability of higher SIGUR level was increased along with the increased HbA1c level ( OR=1.237, P=0.021), while the probability of higher SIGUR level was decreased along with the increased HbA1c level in the non-diabetic group ( OR=0.233, P=0.010). Conclusions:Acute stress hyperglycemia is correlated to the basal blood glucose before cerebral infarction, and blood glucose increases more prominently in those patients with high basal blood glucose level, especially in the diabetic patients.