QUICKI is a Useful Biomarker in Predicting Clinical Outcomes Among Ischemic Stroke Patients Without Type 2 Diabetes Mellitus

Background: The quantitative insulin-sensitivity check index (QUICKI) has an excellent linear correlation with the glucose clamp index of insulin sensitivity (SIClamp). Objective: It is important to investigate whether QUICKI would be useful index of insulin resistance (IR) to predict clinical outcome in ischemic stroke (IS) patients without type 2 diabetes mellitus (T2DM). Methods and Material: Prospective cohort patients who were diagnosed with IS and without a history of T2DM in the ACROSS-China registry were included from May 2008 to December 2009. And, QUICKI was calculated by the formula: 1/[log (fasting insulin, μU/mL) + log (fasting blood glucose, mg/dL)] and split into four quartiles. Results: Of 1149 study participants, recurrent IS, all-cause death, and poor outcome occurred in 169 (14.71%), 72 (6.53%), and 261 (22.72%) cases, respectively in 1-year follow-up. Multivariable Cox proportional hazards analyses showed that the risk of incident primary endpoints was associated with a lower QUICKI quartile. In the Cox proportional hazard model, patients with the first QUICKI had an association with IS recurrence (adjusted hazard ratio, 2.90; 95% CI, 1.26-6.67; P = 0.001) and poor outcome (adjusted hazard ratio, 2.53; 95% CI, 1.06-5.99; P = 0.035), compared with those in the fourth quartile. Furthermore, the Kaplan-Meier survival analysis shown non-diabetic IS patients with a lower QUICKI had a higher mortality. Conclusions: QUICKI as an insulin sensitivity index might be a potential predictor of clinical outcomes for acute IS patients without T2DM.