Association of fasting blood glucose level with 90-day unfavorable outcome in acute ischemic stroke patients.

Objectives: Fasting blood glucose (FBG) is a risk factor for Acute Ischemic Stroke (AIS). We aimed to systematically assess the association of FBG level and 90-day unfavorable outcome in AIS patients.

Methods: FBG levels and related information of the patients were collected at admission. The unfavorable outcome was defined as 90-day mRS 3-6. FBG levels were analyzed as continuous variables and tertiles (Q1-Q3). Odds ratios and 95% confidence intervals were calculated by using multivariate logistic regression analysis.

Results: Overall, 677 AIS patients were included. FBG were significantly associated with unfavorable outcome at 90 days (adjusted OR 1.15 [95%Cl, 1.05-1.25], P = 0.002). Participants were categorized based on the FBG tertile cut-off points, the Odds ratios was 2.55-fold higher in Q3 than those in Q1 after adjusting (OR 2.55[95%Cl, 1.23-5.3], p = 0.012). Threshold effect analysis showed when FBG ≥ 5.5 mmol/L, the correlation between FBG and 90-day unfavorable outcome increased significantly. Subgroup analysis showed that there was no significant interaction between FBG and 90-day unfavorable outcome. Non-diabetic AIS patients with hyperglycemia (FBG ≥ 7 mmol/L) have a worse prognosis in comparison to those with normal glucose (FBG ˂ 5.6 mmol/L) (OR 8.59 [ 95%Cl, 2.24-32.97], p = 0.002).

Conclusion: FBG is an independent predictor of 90-day unfavorable outcome after stroke in AIS patients. When FBG ≥ 5.5 mmol/L, the risk of 90-day unfavorable outcome increases significantly.