Insulin Resistance as an Inflammatory Marker for Ischemic Stroke Severity Among Non-Diabetics: A Prospective Study

Natuva Sai Sampath Kumar, Neeraja Vanamala, Ganesh Vallampalli, Anil Kumar Thatikonda, Ravikiran Padala


Background: Insulin resistance (IR) is one of the inflammatory markers that is receiving increasing attention as a possible early marker of increased risk of cerebrovascular disease. The purpose of the study was to determine the prevalence of IR in non-diabetic ischemic stroke patients and its correlation with the stroke severity.

Methods: It was a prospective study conducted at Narayana Medical College, Nellore from January 2013 to June 2014. After the approval from the institutional ethical committee, patients who presented with the history of stroke, who were non-diabetics and aged > 18 years were included with informed consent. Ischemic stroke was diagnosed with clinical findings and by neuroimaging. Severity of stroke was assessed by National Institutes of Health Stroke Scale (NIHSS) score. Homeostasis model assessment (HOMA) was used to estimate IR and the levels were studied in relation to the stroke severity.

Results: A total of 162 non-diabetic ischemic stroke patients were enrolled in the study. Hyperinsulinemia, i.e., serum insulin > 9 µU/mL, was observed in 41 (25.30%) patients. IR with HOMA-IR ≥ 2.5 was noted in 31 (19.13%) patients. NIHSS score in severity (group III) was strongly associated with serum insulin > 9 µU/mL (54.5%) (P = 0.002) and HOMA-IR ≥ 2.5 (54.5%) (P < 0.0001).

Conclusions: IR may be a novel therapeutic target for stroke prevention. High HOMA-IR was associated with high NIHSS score and it is a useful index for prediction of ischemic stroke in non-diabetics.

J Neurol Res. 2016;6(2-3):46-50


Cerebral infarction; Stroke; Diabetes; Adults; Computerized tomography; Risk factors

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