AUTHOR=Liu Chao , Zhu Xu-ping , Zhu Xiao-wei , Jiang Yan-min , Xi Guang-jun , Xu Lan 

TITLE=The acute-to-chronic glycemic ratio correlates with the severity of illness at admission in patients with diabetes experiencing acute ischemic stroke

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.938612

DOI=10.3389/fneur.2022.938612

ISSN=1664-2295

ABSTRACT=Acute hyperglycemia is a powerful indicator of the severity of acute ischemic stroke (AIS); however, the relationship between these two factors is not that clear in patients with diabetes. We aimed to retrospectively evaluate data from 335 consecutive patients who experienced AIS from November 2015 to November 2016 to investigate whether a comprehensive assessment of blood glucose levels is a more valuable indicator of AIS severity than the presence of acute hyperglycemia in those with diabetes. We collected demographic data, clinical manifestation information, clinical scores, and laboratory data (including fasting blood glucose and glycated hemoglobin (HbA1c) levels). We estimated prehospital mean blood glucose concentrations using the following formula: [1.59 * HbA1c (%)-2.59] to calculate the “Acute-to-Chronic Glycemic Ratio” (AC ratio). The AC ratio differed significantly among patients grouped according to the National Institutes of Health Stroke Scale/Score (NIHSS) at admission (admission NIHSS) (p=0.006). Univariate regression analysis revealed a correlation between the AC ratio and admission NIHSS (standardized β-coefficient (Std. B)=0.164, p=0.004). Both HbA1c (Std. B=0.368, p=0.038) and the AC ratio (Std. B=0.262, p=0.022) were related to admission NIHSS in the adjusted linear regression analysis. The AC ratio (Std. B=0.161, p=0.012) was related to admission NIHSS in the stepwise variable selection. For an admission NIHHS>4, the AC ratio (Std. B=0.186, p=0.047) was related to admission NIHSS in the stepwise variable selection. The AC ratio (Std. B=1.163, p=0.006 and Std. B=0.565, p=0.021, respectively) were related to admission NIHSS in both large-artery atherosclerosis(LAA) and small-vessel occlusion(SVO) subgroups. Thus, the AC ratio is related to admission NIHSS in patients with diabetes who experience AIS and may be a better indicator of severity than acute blood glucose levels.