title: Sex differences in long-term outcomes among acute ischemic stroke patients with diabetes in China.
abstract: BACKGROUND
  Diabetes has been shown to be significantly associated with poor outcome after stroke. However, the sex differences in stroke outcome among patients with diabetes are unknown. Therefore, we aimed to assess the sex differences in long-term prognosis among acute ischemic stroke patients with diabetes.
  
  
  METHODS
  The ischemic stroke patients with diabetes were recruited to this study between May 2005 and September 2014 in Tianjin, China. Sex differences in mortality, dependency (modified rank scale > 2), and recurrence at 3, 12, and 36 months after stroke were analyzed.
  
  
  RESULTS
  A total of 2360 patients were recruited in this study. The age of stroke onset, National Institute of Health stroke scale (NIHSS), and modified rank scale (mRS) on admission were greater in women than in men (P < 0.05). Women were more likely to have hypertension, obesity, atrial fibrillation, and dyslipidemias. In contrast, men were more likely to have artery stenosis, current smoking, and alcohol consumption (P < 0.001). There was higher mortality in women than in men at 3 months (7.9 % vs 5.2 %), 12 months (12.2 % vs 8.2 %), and 36 months (21.9 % vs 16.1 %) after stroke; but no differences were found in dependency and recurrence. Sex differences were found in associated factors of outcomes by time-point. Trial of Org 10172 in Acute Stroke Treatment (TOAST) of large artery atherothrombosis (LAA), cardioembolism (CE), and smoking were risk factors of outcomes in women at short term and medium term; but atrial fibrillation (AF), obesity, and alcohol were risk factors of outcomes in men at medium term and long term.
  
  
  CONCLUSIONS
  These findings suggest that it is crucial to establish the individual scheme of therapy for every patient by different risk factors of stroke, strengthen the rehabilitation of stroke, and carry on the health education early for the secondary prevention of stroke in patients with diabetes mellitus (DM).
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Zhongping
authors.initials: Z
authors.lastname: An
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Guanen
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Department of Ultrasound, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.affiliation: Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Department of Radiology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China ; Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Disease, 122 Qixiangtai Road, Hexi District, 300060 Tianjin China.
authors.forename: Yuanju
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Epidemiology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China ; Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Xianjia
authors.initials: X
authors.lastname: Ning
authors.affiliation: Department of Epidemiology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China ; Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Wang
keywords: Acute ischemic stroke; Diabetes mellitus; Outcome; Risk factors; Sex differences