Stress hormone and blood glucose response following acute stroke in the elderly

Stroke. 1991 Jul;22(7):842-7. doi: 10.1161/01.str.22.7.842.

Abstract

We studied the relation of reactive hyperglycemia, stress hormone response, and outcome in 23 consecutive elderly patients (median age 80 [range 75-92] years) following an acute first stroke. The median delay from the onset of the stroke to the first blood sample (day 0) was 9 (range 4-22) hours. Subsequent blood samples were taken, after fasting, for the determination of blood glucose, cortisol, catecholamine, insulin, C-peptide, glucagon, and lactate concentrations on days 1, 2, 3, 7, 14, 30, and 90. For all 23 patients, a significant relation was found between the blood glucose concentration and survival (p = 0.03) and the blood glucose concentration decreased with time (p less than 0.001). There was also a significant relation between blood glucose concentration and outcome (p = 0.02). For the 15 patients with complete data, the major determinants of the blood glucose concentration were the cortisol, insulin, and glucagon concentrations (all p less than 0.001), which accounted for 42% of the variance. When all the indexes were analyzed together by logistic regression, only the cortisol concentration was related to outcome (p = 0.02). Hyperglycemia following a stroke probably reflects the intensity of the stress hormone response. We have confirmed that hyperglycemia is a predictor of outcome in persons with stroke.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis*
  • Cerebrovascular Disorders / blood*
  • Cerebrovascular Disorders / mortality
  • Female
  • Glucagon / blood
  • Hormones / blood*
  • Humans
  • Hydrocortisone / blood
  • Insulin / blood
  • Male
  • Osmolar Concentration
  • Prospective Studies
  • Regression Analysis
  • Stress, Physiological / blood*
  • Survival Analysis

Substances

  • Blood Glucose
  • Hormones
  • Insulin
  • Glucagon
  • Hydrocortisone