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新诊断急性缺血性脑卒中患者 TyG-BMI 和 TyG-WC 与严重程度及短期预后的相关性。

Correlation of TyG-BMI and TyG-WC with severity and short-term outcome in new-onset acute ischemic stroke.

机构信息

Postgraduate Department, School of Clinical Medicine, Beihua University, Jilin, China.

Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Front Endocrinol (Lausanne). 2024 May 23;15:1327903. doi: 10.3389/fendo.2024.1327903. eCollection 2024.

Abstract

OBJECTIVES

To research the connection between the indexes of the indexes of triglyceride-glucose (TyG) combined with obesity indices and the initial neurological severity and short-term outcome of new-onset acute ischemic stroke.

METHODS

Data of patients with acute ischemic stroke admitted to the Stroke Ward of the Affiliated Hospital of Beihua University from November 2021 to October 2023, were collected. The two indexes were calculated by combining TyG and obesity indices: TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC). The National Institute of Health Stroke Scale (NIHSS) was used to assess and group patients with neurological deficits within 24 hours of admission: mild stroke (NIHSS ≤5) and moderate-severe stroke (NIHSS >5). Short-term prognosis was evaluated using the modified Rankin Scale (mRS) at discharge or 14 days after onset of the disease and grouped: good outcome (mRS ≤2) and poor outcome (mRS >2). According to the quartiles of TyG-BMI and TyG-WC, the patients were placed into four groups: Q1, Q2, Q3 and Q4. Multi-factor logistic regression analysis was utilized to evaluate the correlation of TyG-BMI and TyG-WC with the severity and short-term outcome.

RESULTS

The study included 456 patients. After adjusting for multiple variables, the results showed that compared with the quartile 1, patients in quartile 4 of TyG-BMI had a reduced risk of moderate-severe stroke [Q4: OR: 0.407, 95%CI (0.185-0.894), P = 0.025]; Patients in quartiles 2, 3 and 4 of TyG-BMI had sequentially lower risk of short-term adverse outcomes [Q2: OR: 0.394, 95%CI (0.215-0.722), P = 0.003; Q3: OR: 0.324, 95%CI (0.163-0.642), P = 0.001; Q4: OR: 0.158, 95%CI (0.027-0.349), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of moderate-severe stroke [Q3: OR: 0.355, 95%CI (0.173-0.728), P = 0.005; Q4: OR: 0.140, 95%CI (0.056-0.351), P <0.001]; Patients in quartiles 3 and 4 of TyG-WC had sequentially lower risk of short-term adverse outcomes [Q3: OR: 0.350, 95%CI (0.175-0.700), P = 0.003; Q4: OR: 0.178, 95%CI (0.071-0.451), P <0.001].

CONCLUSIONS

TyG-WC and TyG-BMI were correlated with the severity and short-term outcome of new-onset acute ischemic stroke. As TyG-WC and TyG-BMI increased, stroke severity decreased and short-term outcome was better.

摘要

目的

研究甘油三酯-葡萄糖(TyG)联合肥胖指数的指标与新发急性缺血性卒中初始神经严重程度和短期结局的关系。

方法

收集 2021 年 11 月至 2023 年 10 月在北华大学附属医院卒中病房住院的急性缺血性卒中患者的数据。通过联合 TyG 和肥胖指数计算两个指数:TyG-体重指数(TyG-BMI)和 TyG-腰围(TyG-WC)。采用国立卫生研究院卒中量表(NIHSS)评估入院 24 小时内神经功能缺损患者并分组:轻度卒中(NIHSS≤5)和中重度卒中(NIHSS>5)。采用改良 Rankin 量表(mRS)在发病后或发病后 14 天评估短期预后,并分为:良好预后(mRS≤2)和不良预后(mRS>2)。根据 TyG-BMI 和 TyG-WC 的四分位数,将患者分为四组:Q1、Q2、Q3 和 Q4。采用多因素逻辑回归分析评估 TyG-BMI 和 TyG-WC 与严重程度和短期结局的相关性。

结果

本研究共纳入 456 例患者。调整多个变量后,结果表明,与四分位 1 相比,TyG-BMI 四分位 4 的患者中,中重度卒中的风险降低[四分位 4:OR:0.407,95%CI(0.185-0.894),P=0.025];TyG-BMI 四分位 2、3 和 4 的患者短期不良结局的风险依次降低[四分位 2:OR:0.394,95%CI(0.215-0.722),P=0.003;四分位 3:OR:0.324,95%CI(0.163-0.642),P=0.001;四分位 4:OR:0.158,95%CI(0.027-0.349),P<0.001];TyG-WC 四分位 3 和 4 的患者中重度卒中的风险依次降低[四分位 3:OR:0.355,95%CI(0.173-0.728),P=0.005;四分位 4:OR:0.140,95%CI(0.056-0.351),P<0.001];TyG-WC 四分位 3 和 4 的患者短期不良结局的风险依次降低[四分位 3:OR:0.350,95%CI(0.175-0.700),P=0.003;四分位 4:OR:0.178,95%CI(0.071-0.451),P<0.001]。

结论

TyG-WC 和 TyG-BMI 与新发急性缺血性卒中的严重程度和短期结局相关。随着 TyG-WC 和 TyG-BMI 的增加,卒中的严重程度降低,短期结局更好。

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