title: Hemoglobin A1C is independently associated with severity and prognosis of brainstem infarctions.
abstract: OBJECTIVE
  To assess the association of Hemoglobin A1C (HbA1c) with acute brainstem infarctions (BSIs) and to determine whether HbA1c is an independent risk factor in BSIs patients.
  
  
  METHODS
  96 only BSIs patients were categorized into four groups according to HbA1c as <6%, ≥ 6% but <7%, ≥ 7% but <8%, or ≥ 8%, respectively. The association of the four HbA1c groups with diffusion-weighted imaging (DWI) infarct volumes (DIV), National Institutes of Health Stroke Scale (NIHSS), and follow-up modified Rankin Scale (FmRS) scores were analyzed. Patients also were categorized into two groups according to HbA1c<6% or ≥ 6%. Logistic regression analyses were performed to determine independent risk factors.
  
  
  RESULTS
  There was a significant correlation between HbA1c and DIV (Spearman ρ=0.339, P=0.001), NIHSS scores (ρ=0.292, P=0.004) and FmRS scores (ρ=0.315, P=0.002). The incidence of pons infarction was highest in BSIs and patients with HbA1c ≥ 6% showed significantly more frequent isolated pontine infarction. Logistic regression analyses showed that only HbA1c was independently associated with larger DIV (P=0.025) and FmRS scores (P=0.026).
  
  
  CONCLUSIONS
  These results suggest that elevated HbA1c level may be a potential serologic marker in the evaluation of the severity and prognosis of acute BSIs. There is an urgent need to study control of diabetes mellitus (DM) before and after BSIs.
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, Guangdong, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Li
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Kang
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.forename: Biao
authors.initials: B
authors.lastname: Hu
authors.forename: Ai-Min
authors.initials: AM
authors.lastname: Wu
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Dai
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
authors.forename: Jesse
authors.initials: J
authors.lastname: Luo
authors.forename: Bingjun
authors.initials: B
authors.lastname: Zhang
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D020526:Brain Stem Infarctions / Q000097:blood / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000235:genetics* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human