Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
Nutr Metab Cardiovasc Dis. 2022 Jun;32(6):1477-1484. doi: 10.1016/j.numecd.2022.02.015. Epub 2022 Mar 3.
Few studies have applied the triglyceride, cholesterol, body weight index (TCBI) in acute ischemic stroke (AIS). We investigated the association between the TCBI and adverse clinical outcomes in patients with AIS.
Based on the Third China National Stroke Registry (CNSR-III) data from August 2015 to March 2018, we evaluated the nutritional status of patients with AIS using the TCBI. Patients were categorized according to quartile levels of the TCBI. The main outcomes were poor functional outcomes and recurrent stroke at 1-year and secondary outcomes were adverse outcomes at 3 and 6 months after stroke onset. Poor functional outcomes consisted of all-cause mortality and major disabilities. Multivariate analyses with logistic or Cox regression analysis and restricted cubic splines determined the association between the TCBI and adverse outcomes. We included 9708 patients. At the 1-year follow-up, 1323 patients (13.6%) had died or experienced major disability. The adjusted odds ratios/hazard ratios and 95% confidence intervals of the lowest quartile at 1-year were 1.47 (1.22-1.78) for poor functional outcomes, 1.46 (1.18-1.81) for major disability, and 1.34 (0.94-1.86) for all-cause mortality. Kaplan-Meier analysis demonstrated an inverse relationship between all-cause mortality and the TCBI (log-rank p < 0.05). An approximately L-shaped relationship between TCBI levels and poor functional outcomes and major disability was observed at 1-year.
The novel TCBI was associated with short- and long-term adverse outcomes in AIS. Thus, it may be useful for predicting adverse outcomes in patients with AIS.
很少有研究应用甘油三酯、胆固醇、体重指数（TCBI）来评估急性缺血性脑卒中（AIS）患者的预后。本研究旨在探讨 TCBI 与 AIS 患者不良临床结局的关系。
基于 2015 年 8 月至 2018 年 3 月的中国第三次国家卒中登记研究（CNSR-III）数据，我们使用 TCBI 评估了 AIS 患者的营养状况。患者按照 TCBI 的四分位水平进行分类。主要结局为 1 年时的不良功能结局和复发性卒中，次要结局为卒中发病后 3 个月和 6 个月的不良结局。不良功能结局包括全因死亡和主要残疾。使用 logistic 或 Cox 回归分析和限制三次样条的多变量分析确定了 TCBI 与不良结局之间的关系。我们纳入了 9708 例患者。在 1 年随访时，1323 例（13.6%）患者死亡或发生主要残疾。最低四分位组 1 年时不良功能结局、主要残疾和全因死亡的校正比值比/风险比及其 95%置信区间分别为 1.47（1.22-1.78）、1.46（1.18-1.81）和 1.34（0.94-1.86）。Kaplan-Meier 分析显示全因死亡率与 TCBI 呈负相关（log-rank p<0.05）。1 年时，TCBI 水平与不良功能结局和主要残疾之间呈近似 L 形关系。
新型 TCBI 与 AIS 患者的短期和长期不良结局相关，可能有助于预测 AIS 患者的不良结局。
