Evidence map›Paper›PMID 24968932›Full record

ArticleStroke2014

Racial differences in the association of insulin resistance with stroke risk: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

George Howard, Lynne E Wagenknecht, Walter N Kernan, Mary Cushman, Evan L Thacker, Suzanne E Judd, Virginia J Howard, Brett M Kissela

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

George HowardFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.). ghoward@uab.edu.
Lynne E WagenknechtFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Walter N KernanFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Mary CushmanFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Evan L ThackerFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Suzanne E JuddFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Virginia J HowardFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Brett M KisselaFrom the Department of Biostatistics (G.H., S.E.J.) and Department of Epidemiology (V.J.H.), UAB School of Public Health; Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC (L.E.W.); Department of Medicine, Yale University School of Medicine, New Haven, CT (W.N.K.); Department of Medicine, University of Vermont College of Medicine, Burlington (M.C.); Department of Health Science, Brigham Young University, Provo, UT (E.L.T.); and Department of Neurology, School of Medicine, University of Cincinnati, OH (B.M.K.).
Yale University · USBrigham Young University · USUniversity of Vermont · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
LCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsR01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARY CUSHMAN, VIRGINIA J. HOWARD · 2001 to 2026
$8.8M
NCATS NIH HHS UL1 TR001425NINDS NIH HHS R01 NS041588NINDS NIH HHS U01 NS041588NINDS NIH HHS U01-NS041588
6 · The paper itself

Abstract

background and purposeInsulin resistance is associated with increased stroke risk, but the effect has not been adequately examined separately in white and black populations.

methodsThe association of baseline insulin resistance with risk of cerebral infarction (CI) and intracerebral hemorrhage (ICH) was assessed in 12 366 white and 6782 black participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, recruited between 2003 and 2007 and followed for an average of 5.7 years. Insulin resistance was measured with the homeostasis model assessment-insulin resistance.

resultsThere were 364 incident CI and 41 incident ICH events. The risk for CI increased with the log of insulin resistance in whites (hazards ratio [HR]ln(IR)=1.17; 95% confidence interval [CI], 1.00-1.38) but was largely attenuated by adjustment for stroke risk factors (HRln(IR)=1.05; 95% CI, 0.88-1.26). There was no association in blacks (HRln(IR)=1.01; 95% CI, 0.81-1.25). After adjustment for demographic factors and risk factors, there was a significant difference by race in the association of insulin resistance with risk of ICH (P=0.07), with a decrease in the risk of ICH in whites (HRln(IR)=0.61; 95% CI, 0.35-1.04) but a nonsignificant increase in blacks (HRln(IR)=1.20; 95% CI, 0.60-2.39).

conclusionsThese data support the growing evidence that insulin resistance may play a more important role in stroke risk among white than black individuals and suggest a potentially discordant relationship of insulin resistance on CI and ICH among whites.

Indexed as

AgedBlack or African AmericanBlack PeopleFemaleHumansIncidenceInsulin ResistanceIntracranial HemorrhagesMaleMiddle AgedRiskStrokeWhite Peoplehemorrhageinfarctioninsulin resistancestroke

Identifiers

PMID24968932
PMCPMC4430474
OpenAlexW1995457636

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.