Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China.
School of Nursing, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei, Anhui Province, 230023, China.
BMC Neurol. 2024 Aug 16;24(1):288. doi: 10.1186/s12883-024-03795-w.
This study aimed to evaluate the association between stress hyperglycemia ratio (SHR) and poor functional outcomes at 90 days in patients with acute ischemic stroke (AIS).
This study retrospectively collected 1988 AIS patients admitted to two hospitals in the Shenzhen area between January 2022 and March 2023. A total of 1255 patients with Fasting Blood-glucose (FBG) and hemoglobin A1c (HbA1C) values at admission were included in this analysis. SHR, measured by FBG/HbA1C, was evaluated as both a tri-categorical variable (Tertile 1: ≤ 0.83; Tertile 2: 0.84 -0.95; Tertile 3: ≥ 0.96). The outcome was poor functional outcomes (modified Rankin Scale [mRS] score 2-6) at 90 days. We performed univariate analysis, multiple equation regression analysis, stratified analysis, and interactive analysis.
Compared with patients in the lowest tertile of SHR, the highest tertile group had significantly lower odds of achieving poor functional outcomes (adjusted odds ratio, OR = 2.84, 95% CI: 2.02-3.99, P < 0.0001) at 90 days after adjusting for potential covariates. Similar results were observed after further adjustment for white blood cell count, neutrophil count, lymphocyte count, fasting blood glucose, stroke type, intravenous thrombolytic therapy, baseline Glasgow score, and baseline NIHSS score.
SHR, as measured by the FBG/HbA1C, was associated with an increased odds of achieving poor functional outcomes in patients with AIS at 90 days.
本研究旨在评估急性缺血性脑卒中（AIS）患者应激性高血糖比值（SHR）与 90 天不良功能结局的相关性。
本研究回顾性收集了 2022 年 1 月至 2023 年 3 月期间深圳地区两家医院收治的 1988 例 AIS 患者。共纳入了 1255 例入院时具有空腹血糖（FBG）和糖化血红蛋白（HbA1C）值的患者进行此项分析。SHR 通过 FBG/HbA1C 评估，分为三分类变量（Tertile 1：≤0.83；Tertile 2：0.84-0.95；Tertile 3：≥0.96）。结局为 90 天的不良功能结局（改良 Rankin 量表[mRS]评分 2-6）。我们进行了单变量分析、多元方程回归分析、分层分析和交互分析。
与 SHR 最低三分位组相比，最高三分位组在调整潜在混杂因素后，90 天不良功能结局的发生风险显著降低（调整后的比值比[OR]为 2.84，95%置信区间[CI]为 2.02-3.99，P<0.0001）。在进一步调整白细胞计数、中性粒细胞计数、淋巴细胞计数、空腹血糖、卒中类型、静脉溶栓治疗、基线格拉斯哥评分和基线 NIHSS 评分后，也得到了相似的结果。
通过 FBG/HbA1C 测量的 SHR 与 AIS 患者 90 天的不良功能结局发生风险增加相关。
