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Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study

Intensive glycemic control has not shown consistent findings in stroke prevention for diabetes patients, particularly for those with microvascular complications. This case-control study evaluates the risks of stroke in Asian diabetic population with microvascular complications. From the insurance cl...

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Autores principales: Lo, Sui-Foon, Chen, Wei-Liang, Muo, Chih-Hsin, Chen, Pei-Chun, Chen, Shih-Yin, Kuo, Chih Lan, Sung, Fung-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123532/
https://www.ncbi.nlm.nih.gov/pubmed/30210440
http://dx.doi.org/10.3389/fneur.2018.00719
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author Lo, Sui-Foon
Chen, Wei-Liang
Muo, Chih-Hsin
Chen, Pei-Chun
Chen, Shih-Yin
Kuo, Chih Lan
Sung, Fung-Chang
author_facet Lo, Sui-Foon
Chen, Wei-Liang
Muo, Chih-Hsin
Chen, Pei-Chun
Chen, Shih-Yin
Kuo, Chih Lan
Sung, Fung-Chang
author_sort Lo, Sui-Foon
collection PubMed
description Intensive glycemic control has not shown consistent findings in stroke prevention for diabetes patients, particularly for those with microvascular complications. This case-control study evaluates the risks of stroke in Asian diabetic population with microvascular complications. From the insurance claims of Taiwan, we identified 67,426 type 2 diabetic mellitus (DM) patients with newly diagnosed stroke in 2000–2011 and 134,852 randomly selected controls with DM but without stroke, matched by sex, age, and number of years since diagnosis of DM. Conditional logistic regression analysis measured crude odds ratios (OR) and adjusted odds ratio (aOR) of stroke and 95% confidence intervals (CI) for associations with demographic status, comorbidities, and microvascular complications: retinopathy (RetP), neuropathy (NeuP) or nephropathy (NepP). The aOR of stroke increased significantly associated with each complication: 1.47 with RetP, 1.73 with NeuP and 1.23 with NepP. The risk increased further when there was a combination of complications. The overall aOR of stroke was 2.83 (95% CI 2.58–3.09) for stroke patients with 3 microvascular complications. The corresponding aOR of ischemic stroke was 2.64 (95% CI 2.39–2.91) and that of hemorrhagic stroke was 4.12 (95% CI 3.25–5.22). The number of microvascular complications positively correlated to the prevalence of comorbidity (p < 0.01). This study suggests that microvascular complications are significant stroke predictors, with a greater involvement for ischemic stroke than for hemorrhagic stroke. Multiple microvascular complications interactively increase the stroke risk. Our study contributes to the identification of high-risk subjects for stroke prevention and adequate glycemic control.
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spelling pubmed-61235322018-09-12 Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study Lo, Sui-Foon Chen, Wei-Liang Muo, Chih-Hsin Chen, Pei-Chun Chen, Shih-Yin Kuo, Chih Lan Sung, Fung-Chang Front Neurol Neurology Intensive glycemic control has not shown consistent findings in stroke prevention for diabetes patients, particularly for those with microvascular complications. This case-control study evaluates the risks of stroke in Asian diabetic population with microvascular complications. From the insurance claims of Taiwan, we identified 67,426 type 2 diabetic mellitus (DM) patients with newly diagnosed stroke in 2000–2011 and 134,852 randomly selected controls with DM but without stroke, matched by sex, age, and number of years since diagnosis of DM. Conditional logistic regression analysis measured crude odds ratios (OR) and adjusted odds ratio (aOR) of stroke and 95% confidence intervals (CI) for associations with demographic status, comorbidities, and microvascular complications: retinopathy (RetP), neuropathy (NeuP) or nephropathy (NepP). The aOR of stroke increased significantly associated with each complication: 1.47 with RetP, 1.73 with NeuP and 1.23 with NepP. The risk increased further when there was a combination of complications. The overall aOR of stroke was 2.83 (95% CI 2.58–3.09) for stroke patients with 3 microvascular complications. The corresponding aOR of ischemic stroke was 2.64 (95% CI 2.39–2.91) and that of hemorrhagic stroke was 4.12 (95% CI 3.25–5.22). The number of microvascular complications positively correlated to the prevalence of comorbidity (p < 0.01). This study suggests that microvascular complications are significant stroke predictors, with a greater involvement for ischemic stroke than for hemorrhagic stroke. Multiple microvascular complications interactively increase the stroke risk. Our study contributes to the identification of high-risk subjects for stroke prevention and adequate glycemic control. Frontiers Media S.A. 2018-08-29 /pmc/articles/PMC6123532/ /pubmed/30210440 http://dx.doi.org/10.3389/fneur.2018.00719 Text en Copyright © 2018 Lo, Chen, Muo, Chen, Chen, Kuo and Sung. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Lo, Sui-Foon
Chen, Wei-Liang
Muo, Chih-Hsin
Chen, Pei-Chun
Chen, Shih-Yin
Kuo, Chih Lan
Sung, Fung-Chang
Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title_full Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title_fullStr Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title_full_unstemmed Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title_short Microvascular Parameters Help to Predict Stroke Risk in the Asian Diabetic Population in Taiwan: A Population Based Case-Control Study
title_sort microvascular parameters help to predict stroke risk in the asian diabetic population in taiwan: a population based case-control study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123532/
https://www.ncbi.nlm.nih.gov/pubmed/30210440
http://dx.doi.org/10.3389/fneur.2018.00719
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