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首次缺血性中风后血浆脂联素水平与五年生存率

Plasma adiponectin levels and five-year survival after first-ever ischemic stroke.

作者信息

Efstathiou Stamatis P, Tsioulos Dimitrios I, Tsiakou Aphrodite G, Gratsias Yannis E, Pefanis Angelos V, Mountokalakis Theodore D

机构信息

Center for the Prevention of Cardiovascular Disease, Hygieias Melathron, Athens, Greece.

出版信息

Stroke. 2005 Sep;36(9):1915-9. doi: 10.1161/01.STR.0000177874.29849.f0. Epub 2005 Aug 18.

Abstract

BACKGROUND AND PURPOSE

This study aimed to investigate the association between plasma adiponectin levels and 5-year survival after first-ever ischemic stroke.

METHODS

Plasma adiponectin measured within 24 hours after first-ever ischemic stroke was related to 5-year outcome. The Kaplan-Meier technique was applied in survival analysis, and the Cox proportional hazards model was used to evaluate the relationship between risk factors and prognosis.

RESULTS

The probabilities of death were 92.8%, 52.5%, and 10.5% (P<0.001) for patients stratified according to tertiles of adiponectin (<4 microg/mL, 4 to 7 microg/mL, and >7 microg/mL, respectively). The relative risk of death was 8.1 (95% CI, 3.1, 24.5; P<0.001) for individuals with adiponectin levels in the lowest tertile compared with the upper tertile. Adiponectin <4 microg/mL (hazard ratio [HR], 5.2; 95% CI, 2.1, 18.4; P<0.001), score >15 in the National Institutes of Health Stroke Scale (HR, 3.6; 95% CI, 1.7, 15.9; P<0.001), and coronary heart disease (HR, 2.9; 95% CI, 1.5, 12.3; P<0.001) were independently associated with mortality.

CONCLUSIONS

Low plasma adiponectin is related to an increased risk of 5-year mortality after first-ever ischemic stroke, independently of other adverse predictors.

摘要

背景与目的

本研究旨在探讨首次缺血性卒中后血浆脂联素水平与5年生存率之间的关联。

方法

首次缺血性卒中后24小时内测得的血浆脂联素与5年预后相关。生存分析采用Kaplan-Meier技术,Cox比例风险模型用于评估危险因素与预后之间的关系。

结果

根据脂联素三分位数分层的患者(分别为<4微克/毫升、4至7微克/毫升和>7微克/毫升)的死亡概率分别为92.8%、52.5%和10.5%(P<0.001)。与最高三分位数相比,脂联素水平处于最低三分位数的个体的相对死亡风险为8.1(95%CI,3.1,24.5;P<0.001)。脂联素<4微克/毫升(风险比[HR],5.2;95%CI,2.1,18.4;P<0.001)、美国国立卫生研究院卒中量表评分>15(HR,3.6;95%CI,1.7,15.9;P<0.001)和冠心病(HR,2.9;95%CI,1.5,12.3;P<0.001)与死亡率独立相关。

结论

首次缺血性卒中后,低血浆脂联素与5年死亡风险增加相关,独立于其他不良预测因素。

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