Correlation of HbA1c levels with severity, prognosis and recurrence of patients with cerebral infarction

Abstract

Objective To investigate the correlation of HbAlc levels with severity,prognosis and recurrence of patients with cerebral infarction during the acute stage and a year after onset.Methods Prospective cohort study was performed in the clinical data of 228 inpatients with acute cerebral infarction,admitted to our hospital from September 2006 to September 2010.Levels of glycosylated hemoglobin (HbA1c),fasting plasma glucose (FBG),systolic pressure (SBP),diastolic blood pressure (DBP),cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C) and high density lipoprotein cholesterol (HDL-C) at the acute stage were detected; the living activity scale (Barthel index,BI) was conducted.According to the levels of HbA1c and FBG at admission,the patients were divided into four groups:groups of HbA1c≥6.1 and FBG≥6.1,group of HbA1c≥6.1 and FBG＜6.1,group of HbA1c＜6.1 and FBG≥6.1,and group of HbA1c＜6.1 and FBG＜6.1.Single-factor analysis of variance was employed to analyze the differences of all the indexes at acute stage between each two groups;correlations of BI scores at acute stage and one year after onset with other indexes were explored; t-test was employed to analyze the differences of all the indexes between patients with and without relapsed cerebral infarction.Results During the acute stage of cerebral infarction,significant differences were noted on levels of TC,TG,LDL-C,SBP and BI scores between each groups (P＜0.05); BI scores were negatively correlated with HbA1c and SBP levels.One year after the onset,the BI scores were negatively correlated with HbA1c,FBG,SBP levels at the acute stage,and HbA1c and FBG levels one year after onset,respectively.Overall recurrence rate was 5.88％ after a year of follow up; the HbA1c,FBG and TG levels at acute stage,and FBG and PBG levels one year after onset showed significant differences between patients with and without relapsed cerebral infarction (P＜0.05).Conclusion Patients with increased HbA1c and FBG levels at the acute stage of cerebral infarction have high risk of abnormalities oflipids and blood pressure; high levels ofHbA1c,FBG and SBP at the acute stage indicate severity of the infarction,and HbA1c and SBP levels at the acute stage and HbAlc and FBG levels one year after the onset are the main factors of poor prognosis; levels ofHbA1c,FBG and TG at the acute stage and PBG and FBG levels one year after the onset are closely related to the recurrence ofischemic stroke. Key words: Cerebral infarction; Glycosylated hemoglobin; Prognosis; Recurrence