Dietary Glycemic Index and Glycemic Load in Relation to Atherosclerotic Stenosis of Carotid and Cardiovascular Risk Factors in Ischemic Stroke Patients

Abstract

Aim: Glycemic index (GI) and glycemic load (GL) influence postprandi al glucose concentrations and insulin responses. This study aims to ascertain the connection between GI, GL, and carotid atherosclerotic stenosis and cardiovascular disease (CVD) risk factors.

Methods: A total of 669 patients with ischemic stroke within 7 days were enrolled. GI and GL were assessed with a validated food frequency questionnaire from patients. Computed tomography angiography (CTA) was used for the evaluation of carotid atherosclerotic stenosis. Traditional risk factors such as total cholesterol, triglycerides, LDL-C, HDL-C, C-reactive protein, homocysteine, neutrophil to lymphocyte ratio (NLR), fasting plasma glucose, and hemoglobin A1c were measured. GI/GL and its association with CVD risk factors and carotid stenosis were explored with Spearman analysis and multivariable logistic regression, respectively.

Results: The prevalence of carotid stenosis was 63.2% of all 669 participants. The mean value of GI/GL was 49.3/137. Spearman test did not detect significant relationships between GI/GL and CVD risk factors. In multivariable regression models, GI (4^th vs. 1^st quartile, OR=2.11; 95% CI, 1.30–3.42) and GL (4^th vs. 1^st quartile, OR=1.82; 95% CI, 1.12–2.96) were observed a significant association with carotid stenosis after adjustment for major confounding factors. The association between GL and carotid stenosis became more pronounced among yo ungers (4^th vs. 1^st quartile, OR=2.42; 95% CI, 1.13–4.76) and women (4^th vs. 1^st quartile, OR=3.81; 95% CI, 1.45–5.05).

Conclusion: Higher GI and GL were positively associated with a higher degree of carotid stenosis in these Chinese cerebral infarction patients, especially in younger patients and women.