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甘油三酯-葡萄糖指数与急性缺血性卒中后1年复发性卒中的关联:中国西安卒中注册研究结果

Association between Triglyceride-Glucose Index and 1-Year Recurrent Stroke after Acute Ischemic Stroke: Results from the Xi'an Stroke Registry Study of China.

作者信息

Guo Weiyan, Liu Zhongzhong, Liu Pei, Lu Qingli, Chang Qiaoqiao, Zhang Mi, Huo Yan, Lin Xuemei, Peng Linna, Liu Tong, Yan Yinfang, Lei Zhen, Wang Yuanji, Huang Congli, Zhang Dandan, Wang Fang, Wu Songdi

机构信息

Department of Neurology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an, China.

Xi'an Key Laboratory of Innovation and Transformation of Neuroimmunological Diseases, Xi'an, China.

出版信息

Cerebrovasc Dis. 2024;53(4):391-402. doi: 10.1159/000534240. Epub 2023 Sep 27.

Abstract

INTRODUCTION

The triglyceride-glucose (TyG) index is reported to be related to poor functional outcomes and all-cause mortality post-stroke. However, the association between TyG index and recurrent stroke after acute ischemic stroke (AIS) has not been well described. We aimed to identify whether the TyG index was associated with 1-year recurrent stroke after AIS.

METHODS

Baseline patient information was collected at admission, and the TyG index was calculated. Recurrent stroke events were followed up at 1, 3, 6, and 12 months after diagnosis. We then examined the association between the TyG index and risk of 1-year recurrent stroke using multivariable Cox regression models and restricted cubic spline analyses.

RESULTS

Among 2,288 participants, the mean TyG index was 8.8 ± 0.7. Those in the fourth quartile (Q4) demonstrated higher recurrent stroke risk than those in Q1 (adjusted hazard ratio [HR] = 1.63; 95% confidence interval [CI], 0.98-2.72; p = 0.059). Subgroup analysis revealed a sex-specific association between TyG index and recurrent stroke (p for interaction = 0.022). Additionally, restricted cubic splines analyses showed a nonlinear association between the TyG index and 1-year recurrent stroke. In females, patients in the Q4 had a 2.95-fold increased recurrent stroke risk than did patients in the Q1 (adjusted HR = 2.95; 95% CI: 1.09-7.94; p = 0.032); the risk increased when the TyG index was >8.73. However, no significant correlation was observed in males.

CONCLUSION

A nonlinear association was found between the TyG index and 1-year recurrent stroke risk. Subsequently, a high TyG index could predict an increased 1-year recurrent stroke risk in female AIS patients.

摘要

引言

据报道,甘油三酯-葡萄糖(TyG)指数与中风后功能预后不良和全因死亡率相关。然而,急性缺血性中风(AIS)后TyG指数与复发性中风之间的关联尚未得到充分描述。我们旨在确定TyG指数是否与AIS后1年复发性中风有关。

方法

在入院时收集患者基线信息,并计算TyG指数。在诊断后的1、3、6和12个月对复发性中风事件进行随访。然后,我们使用多变量Cox回归模型和受限立方样条分析来研究TyG指数与1年复发性中风风险之间的关联。

结果

在2288名参与者中,平均TyG指数为8.8±0.7。处于第四四分位数(Q4)的参与者复发性中风风险高于处于第一四分位数(Q1)的参与者(调整后风险比[HR]=1.63;95%置信区间[CI],0.98-2.72;p=0.059)。亚组分析显示TyG指数与复发性中风之间存在性别特异性关联(交互作用p=0.022)。此外,受限立方样条分析显示TyG指数与1年复发性中风之间存在非线性关联。在女性中,处于Q4的患者复发性中风风险比处于Q1的患者高2.95倍(调整后HR=2.95;95%CI:1.09-7.94;p=0.032);当TyG指数>8.73时,风险增加。然而,在男性中未观察到显著相关性。

结论

发现TyG指数与1年复发性中风风险之间存在非线性关联。随后,高TyG指数可预测女性AIS患者1年复发性中风风险增加。

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