Hubungan Resistensi Insulin, Indeks Antropometri dan Indeks Aterogenik Plasma dengan Skor National Institute of Health Stroke Scale pada Pasien Stroke Iskemik Akut Tanpa Diabetes Mellitus

Abstract

Background Stroke is a global health problem whose incidence is increasing every year. Metabolic syndrome is known as an independent risk factor for stroke which is characterized by a group of risk factors: obesity, insulin resistance, hypertension, hypertriglyceridemia and low high density lipoprotein cholesterol (HDL-C). Previous studies have stated that there is a significant relationship between metabolic syndrome and the score of the National Institute of Health Stroke Scale (NIHSS). Objective This study aims to examine the correlation between the insulin resistance, anthropometric index and atherogeic index of plasma (AIP) with NIHSS score in Acute Ischemic Stroke Patients without diabetes mellitus (DM). Methods This research is analytic correlation with cross-sectional design. The study sample consisted of 59 acute ischemic stroke patients without DM. Height, waist circumference and NIHSS scores were assessed on the first day of treatment. Anthropometric index is assessed based on the results of examination of height and waist circumference. The atherogenic index of plasma was assessed based on the examination of the lipid profile. Insulin resistance was assessed based on examination of the lipid profile, fasting blood sugar and waist circumference. Data analysis used the Spearman test. Results The mean age of the 59 subjects is 57,10±11,79 years, the majority were male (57,6%), the majority were Batak (55,9%), the last education was high school (61%), and the majority occupation are Self-employed (40,7%). The mean insulin resistance 441(324.52-624.36) cm.mg/dl, the mean anthropometric index 116.07±12.49 consisting of mean BMI 21.6(17.8-22.7) kg/m2, the mean waist circumference 92(71- 121) ) cm and mean RLP-TB was 0.59 ± 0.08 cm, then the mean AIP was 0.09 ± 0.24 mg/dl and the mean NIHSS score was 4 (2-14). There is a significant weak positive correlation between insulin resistance and the NIHSS score with p <0.012 and r=0.327. There is a significant weak positive correlation between the anthropometric index and the NIHSS score with p <0.025 and r=0.291. There is no significant correlation between AIP and NIHSS scores. Conclusion There is a significant weak positive correlation between insulin resistance and anthropometric index with the NIHSS score of acute ischemic stroke patients without DM.