INSULIN RESISTANCE AS A PREDICTOR OF PROGNOSIS IN NONDIABETIC PATIENTS WITH ACUTE ISCHEMIC STROKE

This study examines the prognostic significance of insulin resistance (IR) in nondiabetic patients with acute ischemic stroke. A cohort of 108 first-ever stroke patients without prior diabetes was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). Patients were categorized into quartiles, with the highest quartile defined as insulin resistant, and followed for 12 months. IR was present in one-quarter of the cohort and was independently associated with increased mortality, higher recurrence rates, and poorer functional outcomes, even after adjusting for vascular risk factors. A clear dose-response relationship was observed, with higher HOMA-IR values correlating with progressively worse outcomes. These findings suggest that metabolic assessment, particularly identification of IR, should be integrated into routine stroke evaluation and secondary prevention strategies.