文献类型：期刊文献

英文题名：Glycated Hemoglobin as a Marker for Predicting Outcomes of Patients With Stroke (Ischemic and Hemorrhagic): A Systematic Review and Meta-Analysis

作者：Bao, Yaya[1];Gu, Dadong[2]

机构：[1]Shaoxing Univ, Med Coll, Shaoxing, Peoples R China;[2]Shaoxing Univ, Zhuji Affiliated Hosp, Dept Neurol, Zhuji, Peoples R China

年份：2021

卷号：12

外文期刊名：FRONTIERS IN NEUROLOGY

收录：SCI-EXPANDED(收录号：WOS:000639813800001)、、Scopus(收录号：2-s2.0-85104144214)、WOS

基金：This study was supported by the Study and Intervention Management of Risk Factors for Stroke Recurrence in the Rural of Zhejiang Province (GF19H090030).

语种：英文

外文关键词：glycated hemoglobin; stroke; glycemic control; ischemic stroke; meta-analysis

外文摘要：Background: Glycated hemoglobin (HbA1c) has emerged as a useful biochemical marker reflecting the average glycemic control over the last 3 months, and the values are not affected by short-term transient changes in blood glucose levels. However, its prognostic value in the acute neurological conditions such as stroke is still not well-established. The present meta-analysis was conducted to assess the relationship of HbA1c with outcomes such as mortality, early neurological complications, and functional dependence in stroke patients. Methods: A systematic search was conducted for the PubMed, Scopus, and Google Scholar databases. Studies, either retrospective or prospective in design that examined the relationship between HbA1c with outcomes of interest and presented the strength of association in the form of adjusted odds ratio/hazard ratios were included in the review. Statistical analysis was done using STATA version 13.0. Results: A total of 22 studies (15 studies on acute ischemic stroke and seven studies on hemorrhagic stroke) were included in the meta-analysis. For patients with acute ischemic stroke, each unit increase in HbA1c was found to be associated with an increased risk of mortality within 1 year, increased risk of poor functional outcome at 3 months, and an increased risk of symptomatic intracranial hemorrhage (sICH) within 24 h of admission. In those with HbA1c >= 6.5%, there was an increased risk of mortality within 1 year of admission, increased risk of poor functional outcomes at 3 and 12 months as well as an increased risk of symptomatic intracranial hemorrhage (sICH) within 24 h of admission. In patients with hemorrhagic stroke, each unit increase in HbA1c was found to be associated with increased risk of poor functional outcome within the first 3 months from the time of admission for stroke. In those with HbA1c >= 6.5%, there was an increased risk of poor functional outcome at 12 months. Conclusions: The findings indicate that glycated hemoglobin (HbA1c) could serve as a useful marker to predict the outcomes in patients with stroke and aid in the implementation of adequate preventive management strategies at the earliest.