The relationship between insulin resistance and hypercoagulability in acute ischemic stroke.
OBJECTIVE
Insulin resistance has effects on the coagulation system, which is important in the acute phase of infarct. We examined the relationships between insulin resistance, hemostatic markers and stroke severity in acute ischemic stroke patients.


METHODS
Protein C (PC), protein S (PS), fibrinogen, von Willebrand factor and antithrombin III (AT III) were studied in 75 acute ischemic stroke patients with and without insulin resistance.


RESULTS
The PC and PS levels of insulin-resistant patients were significantly lower than those of non-insulin-resistant patients (PC: 87 ± 19.23 vs. 97.89 ± 13.3%, p = 0.007; PS: 84.75 ± 15.72 vs. 93.21 ± 15.02%, p = 0.02), and both of the anticoagulants were correlated with the homeostasis model assessment (HOMA; r = -0.339, p = 0.003 and r = -0.481, p = 0.000, respectively). Additionally, the NIH Stroke Scale (NIHSS) score correlated negatively with PS (r = -0.329, p = 0.004) and AT III levels (r = -0.235, p = 0.04). The parameters with positive correlations with NIHSS were fibrinogen (r = 0.270, p = 0.019), fasting glucose (r = 0.358, p = 0.008) and HOMA (r = 0.286, p = 0.013).


CONCLUSIONS
The significant associations between insulin resistance and hemostatic markers may be relevant to stroke severity by causing a procoagulant tendency in acute ischemic stroke.
Ozkul
Ayca
A
Department of Neurology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey. ozkulayca@hotmail.com
Turgut
Eylem Telli
ET
Akyol
Ali
A
Yenisey
Cigdem
C
Kadikoylu
Gurhan
G
Tataroglu
Cengiz
C
Kiylioglu
Nefati
N
D000368:Aged; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D012720:Severity of Illness Index; D013223:Statistics as Topic; D020521:Stroke / Q000150:complications* / Q000378:metabolism; D019851:Thrombophilia / Q000209:etiology* / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism
D011486:Protein C; D017293:Protein S; D014841:von Willebrand Factor; D005340:Fibrinogen