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High Dietary Glycemic Load is Associated with Poor Functional Outcome in Patients with Acute Cerebral Infarction

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Background and Purpose Elevated postprandial blood glucose is a critical risk factor forstroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markersof the postprandial blood glucose response to estimate the overall glycemic effect of diets. Wehypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poorfunctional outcome in patients with acute ischemic stroke. Methods We prospectively included 263 first-ever ischemic stroke patients who completed asemiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intakewere investigated by examining the average frequency of intake during the previous yearbased on reference amounts for various food items. Poor functional outcome was defined as ascore on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. Results The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% ofthem were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRSscore, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein,hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score,early neurological deterioration, and high-grade white-matter hyperintensities revealed that thedietary GL and total carbohydrate intake were associated with a poor functional outcome, withodds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functionaloutcome (p for trend=0.481). Conclusions Increased dietary GL and carbohydrate intake were associated with a poor shorttermfunctional outcome after an acute ischemic stroke.

Abstract

Background and Purpose Elevated postprandial blood glucose is a critical risk factor forstroke. The dietary glycemic load (GL) and glycemic index (GI) are frequently used as markersof the postprandial blood glucose response to estimate the overall glycemic effect of diets. Wehypothesized that high dietary GL, GI, or total carbohydrate intake is associated with a poorfunctional outcome in patients with acute ischemic stroke. Methods We prospectively included 263 first-ever ischemic stroke patients who completed asemiquantitative food-frequency questionnaire. The dietary GL, GI, and total carbohydrate intakewere investigated by examining the average frequency of intake during the previous yearbased on reference amounts for various food items. Poor functional outcome was defined as ascore on the modified Rankin Scale (mRS) of ≥3 at 3 months after stroke. Results The patients were aged 65.4±11.7 years (mean±standard deviation), and 58.2% ofthem were male. A multivariate analysis adjusted for age, sex, marital status, prestroke mRSscore, diabetes mellitus, hyperlipidemia, body mass index, triglycerides, low-density lipoprotein,hemoglobin A1c, stroke classification, and National Institutes of Health Stroke Scale score,early neurological deterioration, and high-grade white-matter hyperintensities revealed that thedietary GL and total carbohydrate intake were associated with a poor functional outcome, withodds ratios for the top quartile relative to the bottom quartile of 28.93 (95% confidence interval=2.82–296.04) and 36.84 (95% confidence interval=2.99–453.42), respectively (p for trend=0.002and 0.002, respectively). In contrast, high dietary GI was not associated with a poor functionaloutcome (p for trend=0.481). Conclusions Increased dietary GL and carbohydrate intake were associated with a poor shorttermfunctional outcome after an acute ischemic stroke.

참고문헌 (41)

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