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甘油三酯-葡萄糖指数与缺血性脑卒中患者颈总动脉内中膜厚度

Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke.

机构信息

Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.

Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Cardiovasc Diabetol. 2022 Mar 18;21(1):43. doi: 10.1186/s12933-022-01472-1.

Abstract

BACKGROUND

Triglyceride glucose (TyG) index was recently reported to be associated with an increased risk of the development and recurrence of cardiovascular events, and atherosclerosis is a main speculative mechanism. However, data on the relationship between TyG index and atherosclerosis, especially in the setting of ischemic stroke, is rare. We aimed to explore the association between TyG index and carotid atherosclerosis in patients with ischemic stroke.

METHODS

A total of 1523 ischemic stroke patients with TyG index and carotid artery imaging data were enrolled in this analysis. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Carotid atherosclerosis was measured by common carotid artery intima-media thickness (cIMT), and abnormal cIMT was defined as a mean cIMT and maximum cIMT value ≥ 1 mm. Multivariable logistic regression models and restricted cubic spline models were used to assess the relationships between TyG index and abnormal cIMT. Risk reclassification and calibration of models with TyG index were analyzed.

RESULTS

The multivariable-adjusted odds ratios (95% CIs) in quartile 4 versus quartile 1 of TyG index were 1.56 (1.06-2.28) for abnormal mean cIMT and 1.46 (1.02-2.08) for abnormal maximum cIMT, respectively. There were linear relationships between TyG index and abnormal mean cIMT (P for linearity = 0.005) and abnormal maximum cIMT (P for linearity = 0.027). In addition, the TyG index provided incremental predictive capacity beyond established risk factors, shown by an increase in net reclassification improvement and integrated discrimination improvement (all P < 0.05).

CONCLUSIONS

A higher TyG index was associated with carotid atherosclerosis measured by cIMT in patients with ischemic stroke, suggesting that TyG could be a promising atherosclerotic marker.

摘要

背景

甘油三酯-葡萄糖(TyG)指数最近被报道与心血管事件的发生和复发风险增加有关,动脉粥样硬化是一个主要的推测机制。然而,关于 TyG 指数与动脉粥样硬化的关系的数据,特别是在缺血性卒中的情况下,很少见。我们旨在探讨 TyG 指数与缺血性卒中患者颈动脉粥样硬化之间的关系。

方法

本分析共纳入了 1523 例有 TyG 指数和颈动脉血管成像数据的缺血性卒中患者。TyG 指数的计算方法为 ln[空腹甘油三酯(mg/dL)×空腹血糖(mg/dL)/2]。颈动脉粥样硬化通过颈总动脉内膜中层厚度(cIMT)进行测量,异常 cIMT 定义为平均 cIMT 和最大 cIMT 值≥1mm。采用多变量逻辑回归模型和限制性立方样条模型评估 TyG 指数与异常 cIMT 之间的关系。分析了 TyG 指数的风险再分类和模型校准。

结果

TyG 指数四分位 4 与四分位 1 相比,异常平均 cIMT 的多变量校正比值比(95%可信区间)分别为 1.56(1.06-2.28),异常最大 cIMT 的比值比分别为 1.46(1.02-2.08)。TyG 指数与异常平均 cIMT (P 线性=0.005)和异常最大 cIMT (P 线性=0.027)之间存在线性关系。此外,TyG 指数提供了超过既定风险因素的增量预测能力,表现为净重新分类改善和综合判别改善的增加(均 P<0.05)。

结论

较高的 TyG 指数与缺血性卒中患者通过 cIMT 测量的颈动脉粥样硬化有关,提示 TyG 可能是一种有前途的动脉粥样硬化标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c77/8933990/318ab2dc5340/12933_2022_1472_Fig1_HTML.jpg

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