Department of Neurology, Beijing Tiantan Hospital, Capital Medical University.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.
J Atheroscler Thromb. 2024 Aug 1;31(8):1162-1178. doi: 10.5551/jat.64704. Epub 2024 Feb 21.
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.
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.
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.
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.
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。
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)。
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。
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。