{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T15:38:02Z","timestamp":1777649882634,"version":"3.51.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Elevated triglyceride and glucose levels are associated with an increased cardiovascular disease risk including ischemic stroke. It is not known whether the response to a combined oral triglyceride and glucose challenge after ischemic stroke improves identification of patients with increased risk for recurrent vascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The prospective, observational Berlin \u201cCream&amp;Sugar\u201d study was conducted at 3 different university hospital sites of the Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Germany, between January 24, 2009 and July 31, 2017. Patients with first-ever ischemic stroke were recruited 3 to 7 days after stroke. An oral triglyceride tolerance test (OTTT) and consecutive blood tests before (t\n                      <jats:sub>0<\/jats:sub>\n                      ) as well as 3 (t\n                      <jats:sub>1<\/jats:sub>\n                      ), 4 (t\n                      <jats:sub>2<\/jats:sub>\n                      ), and 5 hours (t\n                      <jats:sub>3<\/jats:sub>\n                      ) after OTTT were performed in fasting patients. An oral glucose tolerance test was performed in all nondiabetic patients 3 hours after the start of OTTT. Outcomes of the study were recurrent fatal or nonfatal stroke as well as a composite vascular end point including stroke, transient ischemic attack, myocardial infarction, coronary revascularization, and cardiovascular death assessed 1 year after stroke. Cox regression models were used to estimate hazard ratios and corresponding 95% CIs between patients with high versus low levels of triglyceride and glucose levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall 755 patients were included; 523 patients completed OTTT and 1-year follow-up. Patients were largely minor strokes patients with a median National Institutes of Health Stroke Scale score of 1 (0\u20133). Comparing highest versus lowest quartiles of triglyceride levels, neither fasting (adjusted hazard ratio\n                      <jats:sub>t0<\/jats:sub>\n                      , 1.24 [95% CI, 0.45\u20133.42]) nor postprandial triglyceride levels (adjusted hazard ratio\n                      <jats:sub>t3<\/jats:sub>\n                      , 0.44 [95% CI, 0.16\u20131.25]) were associated with recurrent stroke. With regard to recurrent vascular events, results were similar for fasting triglycerides (adjusted hazard ratio\n                      <jats:sub>t0<\/jats:sub>\n                      , 1.09 [95% CI, 0.49\u20132.43]), however, higher postprandial triglyceride levels were significantly associated with a lower risk for recurrent vascular events (adjusted hazard ratio\n                      <jats:sub>t3<\/jats:sub>\n                      , 0.42 [95% CI, 0.18\u20130.95]). No associations were observed between fasting and post\u2013oral glucose tolerance test blood glucose levels and recurrent vascular risk. All findings were irrespective of the diabetic status of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this cohort of patients with first-ever\u201a minor ischemic stroke, fasting triglyceride or glucose levels were not associated with recurrent stroke at one year after stroke. However, higher postprandial triglyceride levels were associated with a lower risk of recurrent vascular events which requires further validation in future studies. Overall, our results do not support the routine use of a combined OTTT\/oral glucose tolerance test to improve risk prediction for recurrent stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.122.038732","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T05:00:18Z","timestamp":1652072418000},"page":"2512-2520","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Combined Oral Triglyceride and Glucose Tolerance Test After Acute Ischemic Stroke to Predict Recurrent Vascular Events: The Berlin \u201cCream&amp;Sugar\u201d Study"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-4557","authenticated-orcid":true,"given":"Alexander H.","family":"Nave","sequence":"first","affiliation":[{"name":"Center for Stroke Research Berlin (CSB) (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Klinik und Hochschulambulanz f\u00fcr Neurologie (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."},{"name":"DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany (A.H.N., K.M., M. Endres)."},{"name":"Berlin Institute of Health (BIH), Berlin, Germany (A.H.N., K.M., M. Endres)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0637-8421","authenticated-orcid":true,"given":"Nurcennet","family":"Kaynak","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin (CSB) (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Klinik und Hochschulambulanz f\u00fcr Neurologie (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0126-3155","authenticated-orcid":true,"given":"Knut","family":"Mai","sequence":"additional","affiliation":[{"name":"DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany (A.H.N., K.M., M. Endres)."},{"name":"Berlin Institute of Health (BIH), Berlin, Germany (A.H.N., K.M., M. Endres)."},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Department of Endocrinology and Metabolism, Germany (K.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8454-9142","authenticated-orcid":true,"given":"Bob","family":"Siegerink","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands (B.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Laufs","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie \u2013 Universit\u00e4tsklinik Leipzig, Germany (U.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-3515","authenticated-orcid":true,"given":"Peter U.","family":"Heuschmann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Epidemiology and Biometry, University W\u00fcrzburg, Germany (P.U.H.)."},{"name":"Clinical Trial Center W\u00fcrzburg, University Hospital W\u00fcrzburg, Germany (P.U.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8471-8049","authenticated-orcid":true,"given":"Thomas G.","family":"Liman","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin (CSB) (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Klinik und Hochschulambulanz f\u00fcr Neurologie (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5073-4665","authenticated-orcid":true,"given":"Martin","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Rehabilitationsklinik Medical Park, Humboldtm\u00fchle, Berlin, Germany (M. Ebinger)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6520-3720","authenticated-orcid":true,"given":"Matthias","family":"Endres","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin (CSB) (A.H.N., N.K., T.G.L., M. Endres), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Germany."},{"name":"Klinik und Hochschulambulanz f\u00fcr Neurologie (A.H.N., N.K., T.G.L., M. 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