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Original article
High HbA1c is associated with higher risk of ischaemic stroke in Pakistani population without diabetes
  1. Ali Zohair Nomani,
  2. Sumaira Nabi,
  3. Shahzad Ahmed,
  4. Mansoor Iqbal,
  5. Haris Majid Rajput,
  6. Suhail Rao
  1. Department of Neurology, Pakistan institute of Medical Sciences, Islamabad, Pakistan
  1. Correspondence to Dr Sumaira Nabi; sumairafn{at}gmail.com

Abstract

Context The role of glycated haemoglobin (HbA1c) in the prediction of ischaemic stroke in individuals without diabetes is underestimated.

Aims We performed a study to analyse the role of HbA1c in the risk prediction of ischaemic stroke in Pakistani population without diabetes. We further studied the difference between HbA1c values of individuals with diabetes and without diabetes with stroke.

Settings and design Single centre, case–control.

Materials and methods In phase I, a total of 233 patients without diabetes with ischaemic stroke and 245 as controls were enrolled. Association of HbA1c levels, lipid profiles and blood pressure recordings with ischaemic stroke was analysed. In phase II, comparison was done between diabetics and non-diabetics with stroke.

Statistical analysis Comparison of the mean variables was performed with Student's t-tests. Logistic regression analysis with ischaemic stroke as the dependent variable was performed for phase I.

Results In phase I, the ischaemic stroke group had significantly higher HbA1c levels (5.9±2.9% vs 5.5±1.6%) compared with controls (p<0.05). Triglyceride cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and HbA1c were the significant determinants of stroke (p<0.05). In phase II, mean HbA1c values were significantly higher in the diabetes group (7.6±2.1 vs 6.1±2.3) (p<0.05) but other parameters were not statistically significantly different (p>0.05).

Conclusions Higher HbA1c indicated a significantly increased risk for ischaemic stroke. An HbA1c value above 5.6% (prediabetic range) predicted future risk of stroke and efforts to maintain glucose level within the normal range (≤5.6%) in individuals with high cardiovascular risk are important.

  • Ischemic Stroke
  • Risk factors
  • Glycosylated haemoglobin (HbA1c)
  • Diabetes mellitus
  • Prediabetes

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/svn-2016-000018

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    Footnotes

    • Funding This work has been carried out without any grants or funds. It has been completed without external financial support and the expenses whatsoever for the purpose of this study have been contributed solely by the author's themselves and no one else.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Hospital Ethics Committee copy submitted.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.