title: Metabolic profile of sub-Saharan African patients presenting with first-ever-in-lifetime stroke: association with insulin resistance.
abstract: BACKGROUND
  To assess the pattern of metabolic profile associated with first stroke episode in a hospital setting in Cameroon.
  
  
  METHODS
  All patients admitted for first-ever-in-lifetime stroke over a 6-month period were eligible for inclusion in the study. The 84% participation rate yielded 57 of 68 patients between 16 and 85 years of age. Fifty-seven control subjects were selected to match patients included for age range, sex, and known hypertension and diabetes. We measured fasting serum glucose, insulin, and lipids in controls and in patients between days 3 and 7 after admission.
  
  
  RESULTS
  Total cholesterol was comparable in patients and controls (172.6 ± 39.5 v 175.4 ± 49.7 mg/dL; P = .75), as were triglycerides (129.4 ± 56.1 v 122.4 ± 60.7 mg/dL; P = .53). high-density lipoprotein cholesterol (HDL-C) levels were lower in patients than in controls (37.4 ± 20.6 v 50.2 ± 18.0 mg/dL; P = .001), with comparable levels of low-density lipoprotein cholesterol (LDL-C; 109.4 ± 43.0 v 100.7 ± 48.8 mg/dL; P = .32). The LDL-C/HDL-C ratio was higher in patients compared to controls (4.0 ± 3.0 v 2.3 ± 1.7; P = .0001), as was the total cholesterol/HDL-C ratio (5.9 ± 3.5 v 3.9 ± 1.8; P = .0001). Compared to controls, stroke patients had higher fasting insulin levels (5.9 ± 5.4 v 2.3 ± 3.2 IU/mL; P < .001) and higher insulin resistance as measured by the homeostatic model assessment of insulin resistance (1.9 ± 2.2 v 0.7 ± 1.0; P = .001).
  
  
  CONCLUSIONS
  Stroke is associated with markers of insulin resistance, low serum levels of HDL, and high total cholesterol/HDL ratio in this African population. Studies with a larger sample size and cohort designs are warranted to explore the causal pathways, persistence of these abnormalities, and population-specific cut points.
authors.affiliation: National Obesity Centre and Health of Population in Transition Research Group, FMBS, University of Yaounde 1, Yaounde, Cameroon. eugene.sobngwi@newcastle.ac.uk
authors.forename: Eugene
authors.initials: E
authors.lastname: Sobngwi
authors.forename: Andre-Pascal
authors.initials: AP
authors.lastname: Kengne
authors.forename: Eric Vounsia
authors.initials: EV
authors.lastname: Balti
authors.forename: Leopold
authors.initials: L
authors.lastname: Fezeu
authors.forename: Brice
authors.initials: B
authors.lastname: Nouthe
authors.forename: Sephirin
authors.initials: S
authors.lastname: Djiogue
authors.forename: Dieudonne
authors.initials: D
authors.lastname: Njamen
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Gautier
authors.forename: Nigel C
authors.initials: NC
authors.lastname: Unwin
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Mbanya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D002163:Cameroon / Q000453:epidemiology; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006761:Hospitals; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000208:ethnology*; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin; D008055:Lipids; D014280:Triglycerides