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(Stroke. 1999;30:1787-1791.)
© 1999 American Heart Association, Inc.
Original Contributions |
Proteinuria Is an Independent Risk Factor for Ischemic Stroke in Non–Insulin-Dependent Diabetes Mellitus
From the Medical Research Unit in Clinical Epidemiology (F.G.-R.) and the Research Group on Diabetes and Chronic Illnesses (F.G.-R., M.R.-M.), General Hospital of the Mexican Social Security Institute (M.R.-M.), Durango, Mexico.
Correspondence to Fernando Guerrero-Romero, MD, Siqueiros 225 esq c/castañeda, 34000 Durango, Dgo., Mexico. E-mail guerrero{at}omanet.com.mx
Background and Purpose—Proteinuria is an independent risk factor for cardiovascular disease in patients with NIDDM. The aim of this study was to assess the relationship between proteinuria and ischemic stroke in subjects with NIDDM, and to determine whether proteinuria is an independent risk factor for stroke.
Methods—We performed a case-control study of 59 diabetic patients
with first-ever ischemic stroke due to thrombotic
arterial occlusion, who were considered cases, and 180
diabetic patients without stroke, matched by gender, age, and diabetes
duration, as a control group. WHO criteria for verified definite or
possible stroke were used to ascertain the diagnosis of stroke. For the
purpose of this study proteinuria was defined as a 24-hour urinary
protein excretion rate of 
20 and <200 µg/min. Risk factors
included were smoking, blood pressure, body mass index, serum total
cholesterol, hyperglycemia, and proteinuria.
Results—Subjects with stroke had higher proteinuria proportion
and systolic and diastolic blood pressures. Both
frequency of antihypertensive treatment and antihypertensive drugs used
were similar among subjects with and without stroke. In
multivariate logistic regression analysis, the
ORs and 95% CIs for the variables identified as risk factors for
stroke were as follows: systolic pressure (OR 3.10; 95% CI
3.01 to 4.21; P=0.03); diastolic pressure
(OR 3.30; 95% CI 1.04 to 4.48; P<0.0001); fasting
glucose 11.1 mmol (OR 1.82; 905% CI 1.4 to 3.8;
P=0.04), HbA1c 9.5% (OR 1.7; 95% CI 1.3 to 5.1;
P<0.01), and proteinuria (OR 3.23; 95% CI 1.06 to
4.36; P<0.0001).
Conclusions—Our case-control study gives evidence that proteinuria is an independent risk factor for ischemic stroke in patients with NIDDM.
Key Words: diabetes mellitus • proteinuria • stroke, ischemic
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