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基于血压状况、性别和年龄的关系,甘油三酯-葡萄糖指数与缺血性脑卒中患者颈动脉斑块的关系。

Relationship between triglyceride-glucose index and carotid artery plaques in ischemic stroke patients: Based on blood pressure status, sex, and age.

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China.

Department of Internal Medicine, Mannheim Medical School of Heidelberg University, Mannheim 68167, Germany.

出版信息

J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107992. doi: 10.1016/j.jstrokecerebrovasdis.2024.107992. Epub 2024 Sep 3.

Abstract

BACKGROUND

Numerous studies have shown that the triglyceride-glucose (TyG) index is a reliable substitute marker for insulin resistance. Nevertheless, its correlation with carotid artery plaques (CAPs) among patients with ischemic stroke (IS) remains to be elucidated.

METHODS

9248 IS patients hospitalized at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine were grouped according to the quartiles of TyG index. Patients were further stratified by blood pressure status, sex, age and hypertension control status. Employing logistic regression to examine the connection between the TyG index and CAPs.Additionally, analyzing the receiver operating characteristic (ROC) curve to evaluate the predictive value of the TyG index for CAPs.

RESULTS

Participants with an elevated TyG index had an increased prevalence of CAPs. The TyG index was positively correlated with CAPs (OR: 1.26, CI: 1.14-1.40, P<0.001). Compared with normal blood pressure and prehypertensive patients, the TyG index was markedly correlated with CAPs among hypertensive patients (OR: 1.29, 95% CI: 1.15-1.44, P<0.001). Females had a higher OR value than males(OR: 1.31, 95% CI: 1.11-1.54, P=0.001 versus OR: 1.24, 95% CI: 1.09-1.41, P=0.001). Older patients (>60 years) had a higher OR value than their middle-aged counterparts (≤60 years) (OR: 1.35; 95% CI: 1.16-1.58, P<0.001 versus OR: 1.20; 95% CI: 1.05-1.37, P=0.007). Patients with poorly-controlled hypertension had a higher OR value than patients with well-controlled hypertension(OR: 1.36; 95% CI: 1.14-1.63, P=0.001 versus OR: 1.24; 95% CI: 1.07-1.44, P=0.003). After adjusting for potential confounding factors, the area under the ROC curve (AUC) value in the overall population, sex-stratified group, hypertensive patients and hypertension control status-stratified group were all above 0.7 (P<0.01), demonstrating good forecasting capability.

CONCLUSIONS

In IS patients, the TyG index was significantly associated with CAPs. Additionally, this correlation was more pronounced in hypertensive patients, females, older individuals and patients with poorly-controlled hypertension.

摘要

背景

大量研究表明,三酰甘油-葡萄糖(TyG)指数是胰岛素抵抗的可靠替代标志物。然而,其与缺血性脑卒中(IS)患者颈动脉斑块(CAPs)的相关性仍有待阐明。

方法

根据 TyG 指数的四分位数,将天津中医药大学第一附属医院收治的 9248 例 IS 患者进行分组。根据血压状况、性别、年龄和高血压控制状况进一步分层。采用 logistic 回归分析 TyG 指数与 CAPs 的关系。此外,分析受试者工作特征(ROC)曲线以评估 TyG 指数对 CAPs 的预测价值。

结果

TyG 指数升高的患者 CAPs 发生率更高。TyG 指数与 CAPs 呈正相关(OR:1.26,95%CI:1.14-1.40,P<0.001)。与正常血压和高血压前期患者相比,高血压患者的 TyG 指数与 CAPs 显著相关(OR:1.29,95%CI:1.15-1.44,P<0.001)。女性的 OR 值高于男性(OR:1.31,95%CI:1.11-1.54,P=0.001 与 OR:1.24,95%CI:1.09-1.41,P=0.001)。年龄较大(>60 岁)的患者 OR 值高于中年患者(≤60 岁)(OR:1.35;95%CI:1.16-1.58,P<0.001 与 OR:1.20;95%CI:1.05-1.37,P=0.007)。血压控制不佳的患者 OR 值高于血压控制良好的患者(OR:1.36;95%CI:1.14-1.63,P=0.001 与 OR:1.24;95%CI:1.07-1.44,P=0.003)。在校正潜在混杂因素后,总体人群、性别分层组、高血压患者和高血压控制状况分层组的 ROC 曲线下面积(AUC)值均大于 0.7(P<0.01),表明具有良好的预测能力。

结论

在 IS 患者中,TyG 指数与 CAPs 显著相关。此外,在高血压患者、女性、年龄较大的患者和血压控制不佳的患者中,这种相关性更为明显。

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