Lu Ping, Cui Lingyun, Wang Yu, Kang Kaijiang, Gu Hongqiu, Li Zixiao, Liu Liping, Wang Yilong, Zhao Xingquan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2021 Apr 16;12:648907. doi: 10.3389/fneur.2021.648907. eCollection 2021.
The relationship between glycosylated hemoglobin (HbA1c) and prognosis of spontaneous intracerebral hemorrhage (SICH) patients has not been fully elucidated. This study aimed to reveal the relationship between HbA1c levels and short-term mortality after patient admission with SICH. It was a large-scale, multicenter, cross-sectional study. From August 1, 2015, to July 31, 2019, a total of 41910 SICH patients were included in the study from the Chinese Stroke Center Alliance (CSCA) program. Finally, we comprehensively analyzed the data from 21,116 patients with SICH. HbA1c was categorized into four groups by quartile. Univariate and multivariate logistic regression analyses were used to assess the association between HbA1c levels and short-term mortality in SICH patients. The average age of the 21,116 patients was 62.8 ± 13.2 years; 13,052 (61.8%) of them were male, and 507 (2.4%) of them died. Compared to the higher three quartiles of HbA1c, the lowest quartile (≤5.10%) had higher short-term mortality. In subgroup analysis with or without diabetes mellitus (DM) patients, the mortality of the Q3 group at 5.60-6.10% was significantly lower than that of the Q1 group at ≤5.10%. After adjustment for potential influencing factors, the ROC curve of HbA1c can better predict the short-term mortality of patients with SICH (AUC = 0.6286 < 0.001). Therefore, we concluded that low or extremely low HbA1c levels (≤5.10%) after stroke were associated with higher short-term mortality in SICH patients, with or without DM.
糖化血红蛋白（HbA1c）与自发性脑出血（SICH）患者预后之间的关系尚未完全阐明。本研究旨在揭示SICH患者入院时HbA1c水平与短期死亡率之间的关系。这是一项大规模、多中心的横断面研究。2015年8月1日至2019年7月31日，中国卒中中心联盟（CSCA）项目共纳入41910例SICH患者。最终，我们综合分析了21116例SICH患者的数据。HbA1c按四分位数分为四组。采用单因素和多因素logistic回归分析评估SICH患者HbA1c水平与短期死亡率之间的关联。21116例患者的平均年龄为62.8±13.2岁；其中13052例（61.8%）为男性，507例（2.4%）死亡。与HbA1c较高的三个四分位数相比，最低四分位数（≤5.10%）的短期死亡率更高。在有或无糖尿病（DM）患者的亚组分析中，HbA1c水平为5.60 - 6.10%的Q3组死亡率显著低于HbA1c水平≤5.10%的Q1组。在对潜在影响因素进行校正后，HbA1c的ROC曲线能够更好地预测SICH患者的短期死亡率（AUC = 0.6286，P < 0.001）。因此，我们得出结论，无论是否患有DM，卒中后低或极低的HbA1c水平（≤5.10%）与SICH患者较高的短期死亡率相关。
