title: Different risk factor profiles for ischemic and hemorrhagic stroke in type 1 diabetes mellitus.
abstract: OBJECTIVE
  Despite the fact that patients with type 1 diabetes mellitus have a markedly increased risk of experiencing a stroke, independent risk factors for stroke and its subtypes in these patients have remained unclear.
  
  
  METHODS
  A total of 4083 patients with type 1 diabetes mellitus from the Finnish Diabetic Nephropathy (FinnDiane) Study, without a history of stroke at baseline, were included. Strokes were classified based on medical files and brain imaging. At baseline, mean age was 37.4±11.8 years, duration of diabetes mellitus was 20.0 (11.0-30.0) years, and 51% were men. During 9.0±2.7 years (36 680 patient-years) of follow-up, 105 patients experienced an ischemic stroke and 44 a hemorrhagic stroke. Cox proportional hazards analyses were performed to determine independent risk factors.
  
  
  RESULTS
  Independent risk factors for ischemic stroke were duration of diabetes mellitus, presence of diabetic nephropathy, higher hemoglobin A1c, higher systolic blood pressure, insulin resistance, and history of smoking, whereas sex, lipids, high-sensitivity C-reactive protein, and the metabolic syndrome were not associated with an increased risk. Diabetic nephropathy, severe diabetic retinopathy, higher systolic blood pressure, and lower body mass index were independently associated with hemorrhagic stroke.
  
  
  CONCLUSIONS
  The risk factor profile for ischemic stroke seems partly different from that of hemorrhagic stroke in patients with type 1 diabetes mellitus.
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Stefanie
authors: S
authors: Hägg
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Lena M
authors: LM
authors: Thorn
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Carol M
authors: CM
authors: Forsblom
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Daniel
authors: D
authors: Gordin
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Markku
authors: M
authors: Saraheimo
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Nina
authors: N
authors: Tolonen
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Johan
authors: J
authors: Wadén
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Ron
authors: R
authors: Liebkind
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Jukka
authors: J
authors: Putaala
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.).
authors: Turgut
authors: T
authors: Tatlisumak
authors: From the Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); Division of Nephrology, Department of Medicine (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.) and Department of Neurology (R.L., J.P., T.T.), Helsinki University Central Hospital, Helsinki, Finland; Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland (S.H., L.M.T., C.M.F., D.G., M.S., N.T., J.W., P.-H.G.); and Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.-H.G.). per-henrik.groop@helsinki.fi.
authors: Per-Henrik
authors: PH
authors: Groop
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis*
chemical_list: D001786:Blood Glucose
keywords: diabetes mellitus, type 1; risk factors; stroke