title: Insulin resistance in patients with stroke is related to visceral fat obesity and adipocytokines.
abstract: Insulin resistance is associated with hyperglycemia and dyslipidemia and promotes atherosclerosis. Although insulin resistance is associated with adipocytokines, little is known about the association in patients with stroke without diabetes mellitus. The aim of the current study was to examine the relationship among insulin resistance, visceral fat area, and adipocytokines in patients with stroke. This study design was cross-sectional in a university hospital. We studied 60 patients with stroke and no history of diabetes mellitus who had hyperglycemia or hypertriglyceridemia or reduced fasting plasma high-density lipoprotein cholesterol. We measured insulin resistance, the plasma level of tumor necrosis factor (TNF)-alpha, adiponectin, and the visceral fat area. Insulin resistance was defined by the homeostasis model assessment and the level of insulin at 120 minutes after consuming oral glucose. We classified two groups (insulin sensitive or insulin resistant). In all, 21 of 60 patients (35.0%) had insulin resistance and 35 (58.3%) had hyperinsulinemia. Compared with insulin-sensitive patients with stroke (n = 18), insulin-resistant patients with stroke (n = 21) had significantly wider visceral fat areas and a high level of plasma TNF-alpha. The plasma level of adiponectin in insulin-resistant patients with stroke was similar to that in insulin-sensitive patients. Insulin-resistant patients with stroke in this study had a large amount of visceral fat and increased levels of TNF-alpha. We recommend that obese patients with stroke should be examined for insulin resistance to reduce the risk of the development of atherosclerosis.
authors.affiliation: Department of Rehabilitation Medicine, Saitama Medical University, Saitama, Japan. hissy@saitama-med.ac.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Hishinuma
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Majima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kurabayashi
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D052242:Adiponectin / Q000097:blood / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006946:Hyperinsulinism / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D054392:Adipokines; D052242:Adiponectin; D008076:Cholesterol, HDL; D014409:Tumor Necrosis Factor-alpha