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July2004 Vol.41 Issue:        2        Table of Contents
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Proteinuria as a risk factor for ischemic stroke in non-insulin - dependent diabetes mellitus

Hassan A.A., Amr Kamel , Sarhan A.A.


Department of Neurology, Zagazig University


Objective: This study was designed to assess the relation between proteinuria and other factors in one hand and ischemic stroke in the other hand in subjects with NIDDM. Methods: Two groups of patients were included in this study, 60 NIDDM patients with ischemic stroke and 60 NIDDM patients without stroke. The two groups were matched regarding age, gender  and duration of DM. The patients were evaluated clinically using Glasgow Coma Scale (GCS) for comatose patients and Canadian Neurological scale (CNS) for conscious patients. Routine laboratory investigations as well as 24 hours urine protein were measured for both groups. CT scans were performed to all patients of group I within  the first week after onset of stroke and both size and depth of lesions were evaluated. Results: Systolic and diastolic blood pressures, prevalence of smokers and 24 hours proteinuria were significantly higher in stroke NIDDM patients than NIDDM patients without stroke. There was no significant relation between proteinuria and age, sex, duration of DM random blood glucose level, SBP, DBP, smoking and lipid profile. In multivariate logistic regression analysis, the ORs and 95% CLs for the variables identified as risk factors for stroke were as follows, SBP (OR, 14.5; 95% CI 2.5 to 17.9) ; DBP (OR, 13.1, 95% CI 1-9 to 15.9); proteinuria (OR, 7.6, 95% CI 2.5-22.9); and smoking (OR, 4.89, 95% CI 1.07-22.3). There were non-significant relations between proteinuria and severity of stroke in NIDDM patients with stroke. Furthermore, there were non-significant relations between proteinuria  and CT findings regarding the size and the depth of infarcts in NIDDM patients with stroke. Conclusion: Our results give evidence that proteinuria (³ 20< 200mg/m) is an independent risk factor for ischemic stroke in patients with NIDDM.

(Egypt J. Neurol. Psychiat. Neurosurg., 2004, 41(2): 581-589).      


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