Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis

Introduction Insulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scient...

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Main Authors: Dar Dowlatshahi, Tim Ramsay, Woojin Kim, Brian Dewar, Michel Shamy, Alexandra Davis, Jeremiah Hadwen
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/3/e044771.full
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author Dar Dowlatshahi
Tim Ramsay
Woojin Kim
Brian Dewar
Michel Shamy
Alexandra Davis
Jeremiah Hadwen
author_facet Dar Dowlatshahi
Tim Ramsay
Woojin Kim
Brian Dewar
Michel Shamy
Alexandra Davis
Jeremiah Hadwen
author_sort Dar Dowlatshahi
collection DOAJ
description Introduction Insulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.Methods and analysis The authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by I².Ethics and dissemination No human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.PROSPERO registration number CRD42020173608.
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spelling doaj-art-0a28256120e3493dbcf9aa92002e49942024-11-17T18:10:09ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-044771Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysisDar Dowlatshahi0Tim Ramsay1Woojin Kim2Brian Dewar3Michel Shamy4Alexandra Davis5Jeremiah Hadwen6Department of Medicine, University of Ottawa, Ottawa, Ontario, CanadaClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaNeurology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, CanadaOttawa Hospital & Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaOttawa Hospital Research Institute, Ottawa, Ontario, CanadaRoyal Ottawa Mental Health Centre, Ottawa, Ontario, CanadaNeurology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, CanadaIntroduction Insulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.Methods and analysis The authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by I².Ethics and dissemination No human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.PROSPERO registration number CRD42020173608.https://bmjopen.bmj.com/content/11/3/e044771.full
spellingShingle Dar Dowlatshahi
Tim Ramsay
Woojin Kim
Brian Dewar
Michel Shamy
Alexandra Davis
Jeremiah Hadwen
Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
BMJ Open
title Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
title_full Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
title_fullStr Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
title_full_unstemmed Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
title_short Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis
title_sort association between insulin resistance and post ischaemic stroke outcome in patients without diabetes protocol for a systematic review and meta analysis
url https://bmjopen.bmj.com/content/11/3/e044771.full
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