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载脂蛋白 B 与非高密度脂蛋白胆固醇对急性缺血性卒中和短暂性脑缺血发作患者临床结局的影响

Low-Density Lipoprotein Cholesterol to Triglyceride Ratio and Clinical Outcomes after Acute Ischaemic Stroke or Transient Ischaemic Attack.

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University.

China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.

出版信息

J Atheroscler Thromb. 2024 Aug 1;31(8):1162-1178. doi: 10.5551/jat.64704. Epub 2024 Feb 21.

Abstract

AIMS

Studies showed that low-density lipoprotein cholesterol (LDL-C) to triglyceride (TG) ratio could be used as a predictive parameter of low-density lipoprotein oxidation in vivo and the level of small dense LDL-C. However, whether LDL-C/TG ratio is associated with stroke prognosis remains unclear. We investigated the associations of LDL-C/TG ratio with outcomes in patients with acute ischaemic stroke (AIS) or transient ischaemic attacks (TIA) and explored whether it produced more predictive value than LDL-C and TG.

METHODS

Data were derived from the Third China National Stroke Registry (CNSR-III). Multivariable Cox regression for stroke recurrence, composite vascular events and all-cause death and logistic regression for the poor functional outcome (modified Rankin Scale score 3-6) were used.

RESULTS

A total of 14123 patients were included. After adjusting for confounding factors, quartile 4 of LDL-C/TG ratio was associated with an increased risk of recurrent stroke (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03-1.56), composite vascular events (HR,1.23; 95% CI, 1.00-1.52), death (HR,1.70; 95% CI, 1.13-2.54) and poor functional outcome (odds ratio, 1.34; 95% CI, 1.12-1.61) at 3 months follow-up compared with quartile 1. We also found that quartile 4 of LDL-C and TG was positively and negatively associated with poor functional outcome at 3 months, respectively. LDL-C/TG ratio performed better than LDL-C or TG in predicting clinical outcomes.

CONCLUSIONS

LDL-C/TG ratio was associated with the risk of stroke recurrence, composite vascular events, death and poor functional outcome in patients with AIS or TIA.

摘要

目的

研究表明,低密度脂蛋白胆固醇(LDL-C)与甘油三酯(TG)的比值可作为体内低密度脂蛋白氧化和小而密 LDL-C 水平的预测参数。然而,LDL-C/TG 比值与卒中预后的关系尚不清楚。我们研究了 LDL-C/TG 比值与急性缺血性卒中和短暂性脑缺血发作(TIA)患者结局的相关性,并探讨了它是否比 LDL-C 和 TG 具有更高的预测价值。

方法

数据来自第三次中国国家卒中登记研究(CNSR-III)。采用多变量 Cox 回归分析卒中复发、复合血管事件和全因死亡,采用 logistic 回归分析不良功能结局(改良 Rankin 量表评分 3-6 分)。

结果

共纳入 14123 例患者。调整混杂因素后,LDL-C/TG 比值四分位 4 与复发性卒中(风险比 [HR],1.27;95%置信区间 [CI],1.03-1.56)、复合血管事件(HR,1.23;95% CI,1.00-1.52)、死亡(HR,1.70;95% CI,1.13-2.54)和 3 个月随访时不良功能结局(优势比,1.34;95% CI,1.12-1.61)的风险增加相关,与四分位 1 相比。我们还发现,LDL-C 和 TG 的四分位 4 分别与 3 个月时不良功能结局呈正相关和负相关。LDL-C/TG 比值在预测临床结局方面优于 LDL-C 或 TG。

结论

LDL-C/TG 比值与 AIS 或 TIA 患者卒中复发、复合血管事件、死亡和不良功能结局的风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5764/11300661/95286c7882f8/31_64704_1.jpg

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