甘油三酯/血糖指数在高胆固醇血症合并急性缺血性卒中患者中的预测作用
The Predictive Role of the Triglyceride/Glucose Index in Patients with Hypercholesterolemia and Acute Ischemic Stroke.
作者信息
Kourtidou Christodoula, Ztriva Eleftheria, Kostourou Danai-Thomais, Polychronopoulos Georgios, Satsoglou Sarantis, Chatzopoulos Georgios, Kontana Anastasia, Tzavelas Marios, Valanikas Evripidis, Veneti Stavroula, Sofogianni Areti, Milonas Dimitrios, Papagiannis Achilleas, Savopoulos Christos, Tziomalos Konstantinos
机构信息
First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece.
出版信息
Rev Cardiovasc Med. 2022 Dec 9;23(12):399. doi: 10.31083/j.rcm2312399. eCollection 2022 Dec.
BACKGROUND
The triglyceride/glucose index (TyG) reflects insulin resistance and predicts the risk of acute ischemic stroke (aIS). However, it is uncertain if this index predicts the severity and outcome of aIS because studies that addressed this question are few and all were performed in Asian subjects. Moreover, there are no studies that focused on patients with hypercholesterolemia.
METHODS
We studied 997 Caucasian patients who were hospitalized for aIS and had hypercholesterolemia. aIS severity was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS) and severe aIS was defined as NIHSS 21. The outcome was assessed with the functional outcome at discharge and with in-hospital mortality. An unfavorable functional outcome was defined as modified Rank in scale (mRs) at discharge between 3 and 6.
RESULTS
The TyG index did not correlate with the NIHSS at admission (r = 0.032, = NS) and was similar in patients with severe and non-severe aIS (8.7 0.6 and 8.6 0.6, respectively; = NS). Risk factors for severe aIS were age, female gender, atrial fibrillation (AF) and diastolic blood pressure (DBP) at admission. The TyG index also did not correlate with the mRs(r = 0.037, = NS) and was similar in patients who had unfavorable and favorable functional outcome (8.7 0.6 and 8.6 0.5, respectively; = NS). Risk factors for unfavorable functional outcome were age, previous ischemic stroke, body mass index and the NIHSS at admission. The TyG index was similar in patients who died during hospitalization and patients who were discharged (8.7 0.6 and 8.7 0.6, respectively; = NS). Risk factors for in-hospital mortality were AF and DBP and NIHSS at admission.
CONCLUSIONS
The TyG index does not appear to be associated with the severity or the outcome of aIS. Nevertheless, since there are few relevant data in Caucasians and the TyG index is an inexpensive and widely available biomarker, more studies in this ethnic group are required to determine the predictive role of this index in patients with aIS.
背景
甘油三酯/血糖指数（TyG）反映胰岛素抵抗并预测急性缺血性卒中（aIS）风险。然而，该指数是否能预测aIS的严重程度和预后尚不确定，因为针对此问题的研究较少，且均在亚洲人群中开展。此外，尚无研究聚焦于高胆固醇血症患者。
方法
我们研究了997例因aIS住院且患有高胆固醇血症的白种人患者。入院时采用美国国立卫生研究院卒中量表（NIHSS）评估aIS严重程度，严重aIS定义为NIHSS≥21。出院时通过功能转归及院内死亡率评估预后。不良功能转归定义为出院时改良Rankin量表（mRs）评分为3至6分。
结果
TyG指数与入院时的NIHSS无相关性（r = 0.032，P =无统计学意义），在严重和非严重aIS患者中相似（分别为8.7±0.6和8.6±0.6；P =无统计学意义）。严重aIS的危险因素为年龄、女性、心房颤动（AF）及入院时舒张压（DBP）。TyG指数与mRs也无相关性（r = 0.037，P =无统计学意义），在功能转归不良和良好的患者中相似（分别为8.7±0.6和8.6±0.5；P =无统计学意义）。不良功能转归的危险因素为年龄、既往缺血性卒中、体重指数及入院时NIHSS。住院期间死亡患者和出院患者的TyG指数相似（分别为8.7±0.6和8.7±0.6；P =无统计学意义）。院内死亡的危险因素为AF、DBP及入院时NIHSS。
结论
TyG指数似乎与aIS的严重程度或预后无关。然而，由于白种人中相关数据较少，且TyG指数是一种廉价且广泛可用的生物标志物，因此需要在该种族群体中开展更多研究，以确定该指数在aIS患者中的预测作用。
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