期刊
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
卷 31, 期 3, 页码 807-818出版社
SAGE PUBLICATIONS INC
DOI: 10.1038/jcbfm.2010.210
关键词
blood glucose; cerebrovascular disease; focal cerebral ischaemia; hyperglycaemia; insulin; stroke
资金
- Stroke Association
- Chief Scientists Office (Scotland)
- Chief Scientist Office [CZB/4/746] Funding Source: researchfish
Poststroke hyperglycaemia (PSH) is common, has an unclear pathophysiology, and is associated with poor outcomes. Animal studies report conflicting findings. We systematically reviewed the effects of hyperglycaemia on infarct volume in middle cerebral artery occlusion (MCAO) models, generating weighted mean differences between groups using random effects models summarised as effect size (normalised to control group infarct volume as 100%) and 95% confidence interval. Of 72 relevant papers, 23 reported infarct volume. Studies involved 664 animals and 35 distinct comparisons. Hyperglycaemia was induced by either streptozotocin (STZ, 17 comparisons, n = 303) or dextrose (18 comparisons, n = 356). Hyperglycaemic animals had infarcts that were 94% larger, but STZ was associated with significantly greater increase in infarct volumes than dextrose infusion (140% larger versus 48% larger). In seven studies, insulin did not significantly reduce infarct size and results were heterogeneous. Although hyperglycaemia exacerbates infarct volume in MCAO models, studies are heterogeneous, and do not address the common clinical problem of PSH because they have used either the STZ model of type I diabetes or extremely high glucose loads. Insulin had a nonsignificant and significantly heterogeneous effect. Further studies with relevant models may inform clinical trial design. Journal of Cerebral Blood Flow & Metabolism (2011) 31, 807-818; doi:10.1038/jcbfm.2010.210; published online 15 December 2010
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