Thromb Haemost 2002; 88(06): 950-953
DOI: 10.1055/s-0037-1613339
Involvement of Thrombin Receptors in the Subject-dependent Variability in Ca2+ Signal Generation
Schattauer GmbH

Clustering of Thrombotic Factors with Insulin Resistance in South Asian Patients with Ischaemic Stroke

Kirti Kain
1   Academic Unit of Molecular Vascular Medicine, Leeds General Infirmary, Leeds, United Kingdom
,
Andrew J. Catto
1   Academic Unit of Molecular Vascular Medicine, Leeds General Infirmary, Leeds, United Kingdom
,
Peter J. Grant
1   Academic Unit of Molecular Vascular Medicine, Leeds General Infirmary, Leeds, United Kingdom
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Publikationsverlauf

Received 08. April 2002

Accepted after revision 05. August 2002

Publikationsdatum:
09. Dezember 2017 (online)

Summary

We aimed to investigate significant correlations of insulin resistance with thrombotic factors in South Asians with stroke. Correlations of Homeostasis Model Assessment (HOMA)(as a surrogate of insulin resistance) were analysed with 6 thrombotic factors in 140 South Asian patients with a history of confirmed (by computerised tomography) ischaemic stroke. Age and sex adjusted HOMA was correlated to waist-hip ratio (r = 0.38, p = 0.0001), triglycerides (r = 0.22, p = 0.03), systolic blood pressure (r = 0.21, p = 0.04), tissue plasminogen activator (t-PA) (r = 0.22, p = 0.04); plasminogen activator inhibitor 1(PAI-1) (r = 0.26, p = 0.02); fibrinogen (r = 0.25, p = 0.02); and factor VII antigen (r = 0.21, p = 0.06). On regression analysis, with HOMA as dependent variable and significant correlates as independent variables in the model, HOMA was independently associated with PAI-1 antigen. There is extensive clustering of metabolic and thrombotic factors with insulin resistance in South Asian patients with ischaemic stroke, which may contribute to high prevalence of vascular disease in this population.

 
  • References

  • 1 Pyorala M, Miettinen H, Laakso M, Pyorala K. Hyperinsulinemia and the risk of stroke in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Stroke 1998; 29 (09) 1860-6.
  • 2 Lakka HM, Lakka TA, Tuomilehto J, Sivenius J, Salonen JT. Hyperinsulinemia and the risk of cardiovascular death and acute coronary and cerebrovascular events in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Arch Intern Med 2000; 160 (08) 1160-8.
  • 3 Juhan-Vague I, Alessi MC, Vague P. Thrombogenic and Fibrinolytic Factors and Cardiovascular Risk in Non-insulin-dependent Diabetes Mellitus. Ann Med 1996; 28 (04) 371-80.
  • 4 Juhan-Vague I, Thompson SG, Jespersen J. Involvement of the hemostatic system in the insulin resistance syndrome. A study of 1500 patients with angina pectoris. The ECAT Angina Pectoris Study Group. Arterioscler Thromb 1993; 13 (12) 1865-73.
  • 5 Wild S, McKeigue PM. Cross sectional analysis of mortality by country of birth in England and Wales, 1970–92. BMJ 1997; 314 7082 705-10.
  • 6 McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337 8738 382-6.
  • 7 Kain K, Catto AJ, Grant PJ. Impaired fibrinolysis and increased fibrinogen levels in South Asian subjects. Atherosclerosis 2001; 156 (02) 457-61.
  • 8 Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA. et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet 2000; 356 9226 279-84.
  • 9 Kain K, Catto AJ, Young J, Bamford J, Bavington J, Grant PJ. Increased Fibrinogen, von Willebrand Factor and Tissue Plasminogen Activator Levels in Insulin Resistant South Asian Patients with Ischaemic Stroke. Atherosclerosis 2002; 63 (02) 371-6.
  • 10 Bamford J, Sandercock PA, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991; 337 8756 1521-6.
  • 11 Shinozaki K, Naritomi H, Shimizu T, Suzuki M, Ikebuchi M, Sawada T. et al. Role of insulin resistance associated with compensatory hyperinsulinemia in ischemic stroke. Stroke 1996; 27 (01) 37-43.
  • 12 Pyorala M, Miettinen H, Halonen P, Laakso M, Pyorala K. Insulin resistance syndrome predicts the risk of coronary heart disease and stroke in healthy middle-aged men: the 22-year follow-up results of the Helsinki Policemen Study. Arterioscler Thromb Vasc Biol 1999; 20 (02) 538-44.
  • 13 Wilhelmsen L, Svärdsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311 (08) 501-5.
  • 14 Ridker PM, Hennekens CH, Stampfer MJ, Manson JE, Vaughan DE. Prospective study of endogenous tissue plasminogen activator and risk of stroke. Lancet 1994; 343 8903 940-3.
  • 15 Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P. Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart 1997; 78 (06) 555-63.
  • 16 Kain K, Catto AJ, Young J, Bamford J, Bavington J, Grant PJ. Insulin resistance and elevated levels of tissue plasminogen activator in first-degree relatives of South Asian patients with ischemic cerebrovascular disease. Stroke 2001; 32 (05) 1069-73.