Study On Relationship Between Insulin Resistance And Acute Cerebral Infarction, The Severity Of Acute Cerebral Infarction, Neuron Specific Enolase

Objective: To investigate the presence of the phenomenon of insulin resistance (IR) in patients with acute cerebral infarction ,the relationship between IR and the severity of acute cerebral infarction, neuron specific enolase .Methods: 75 patients diagnosed with acute cerebral infarction were chosen, who were inpatients cared in the No.5 People Hospital from Jan 2005 to Jan 2007.All the patients were diagnosed according to the diagnosis standard which formulated on the 4th session of national cerebrovascular disease academic conference in October, 1995 China Medical Association, now that going to history there were no hypertension, diabetes, cerebral hemorrhage ,tumor. The patients receiving medical checkup in the clinic as control group were also chosen. Among acute cerebral infarction group 49 for male ,26 for female , from 50 to 85 years old ,average 69.8±7.19; The control group was consisted of 55 cases ,among which 25 for male ,30 for female , from 33 to 81 years old ,average 58.1±12.30. The FPG, FINS, FIB, TC,TG,LDL,HDL,ApoA,ApoB,UA,NSE were detected on two groups at the same time . The body mass index (BMI), insulin sensitivity index (ISI), insulin resistance index (HOMA-IR) were calculated .Then the statistics were entered into the computer and analyzed by the SPSS statistic analysis software.Results:1. Single factor analysis :There were significant differences in FPG, FINS, HOMA-IR, FIB, NSE, TG, TC, LDL, HDL and ISI(P<0.05 or P <0.01) between acute cerebral infarction group and control group .Logistic regression analysis: FPG,FINS, TG, TC, LDL and ISI are the risk factors of acute cerebral infarction.2. Single factor analysis :There were significant differences in FPG, FINS,HOMA-IR,NSE and ISI (P<0.05 or P <0.01) between the mild group and moderate-severe group with acute cerebral infarction. Logistic regression analysis: FPG, FINS and ISI are the risk factors of moderate-severe group with acute cerebral infarction.3. There were significant difference in FPG, FINS, HOMA-IR, TC and ISI (P<0.05 or P <0.01) between NSE changed and none NSE changed.4. Linear correlation analysis: ISI was negatively correlated with the score of Neurological impairment (r = - 0.651, P <0.01). 5. Linear correlation analysis: ISI was negatively correlated with NSE(r = -0.524, P <0.01).Conclusions:1. IR does exists in acute cerebral infarction .IR is one of the risk factors of acute cerebral infarction. Improving IR is beneficial to prevent acute cerebral infarction.2. IR in the moderate-severe group were severer than that in the mild group;Severity of which is related to the score of neurological impairment. FPG, FINS and ISI are the risk factors of moderate-severe group with acute cerebral infarction.3. There was significant difference in NSE between the mild group andmoderate- severe group with acute cerebral infarction. So the changes of plasma NSE values can be seen as a specific parameter for assessing the degree of acute cerebral infarction.4. ISI of acute cerebral infarction was negatively correlated with NSE.