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糖化白蛋白水平与中国急性缺血性脑卒中患者的不良卒中结局相关。

Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China.

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.

出版信息

J Diabetes. 2024 Sep;16(9):e13600. doi: 10.1111/1753-0407.13600.

Abstract

BACKGROUND AND AIM

Glycated albumin (GA) is a biomarker monitoring glycemia 2-4 weeks before stroke onset. This study was designed to explore the association between GA levels with poststroke outcomes in patients with acute ischemic stroke or transient ischemic attack (TIA).

METHOD

Participants with ischemic stroke or TIA who had a baseline GA measurement were included in the Third China National Stroke Registry study. The effect of GA on stroke recurrence, poor functional outcomes, and combined vascular events was examined during the 1-year follow-up period. Multivariate Cox and logistic regression models were performed to evaluate the association. Discrimination tests were used to examine the incremental predictive value of GA when incorporating it into the conventional model.

RESULTS

A total of 3861 participants were enrolled. At the 3-month follow-up, the elevated GA level was associated with an increased risk of poor functional outcomes (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.01-2.09). A similar increase was observed for stroke recurrence (adjusted hazard ratio [HR], 1.56; 95% CI, 1.09-2.24), poor functional outcomes (adjusted OR, 1.62; 95% CI, 1.07-2.45), and combined vascular events (adjusted HR, 1.55; 95% CI, 1.09-2.20) at the 1-year follow-up. In nondiabetic patients, the association between GA and poor functional outcomes was more pronounced (adjusted OR, 1.62; 95% CI, 1.05-2.50). Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes (net reclassification improvement [NRI]: 12.30% at 1 year).

CONCLUSION

This study demonstrated that elevated GA levels in serum were associated with stroke adverse outcomes, including stroke recurrence, poor functional outcomes, and combined vascular events, in patients with ischemic stroke or TIA.

摘要

背景与目的

糖化白蛋白(GA)是一种在卒中发病前 2-4 周监测血糖的生物标志物。本研究旨在探讨急性缺血性卒中和短暂性脑缺血发作(TIA)患者中 GA 水平与卒中后结局的相关性。

方法

纳入参加中国第三次国家卒中登记研究的基线时检测到 GA 的缺血性卒中和 TIA 患者。在 1 年的随访期间,评估 GA 对卒中复发、不良功能结局和复合血管事件的影响。使用多变量 Cox 和逻辑回归模型评估相关性。使用判别检验评估 GA 纳入常规模型时的增量预测价值。

结果

共纳入 3861 名患者。在 3 个月的随访中,GA 水平升高与不良功能结局风险增加相关(校正比值比 [OR],1.45;95%置信区间 [CI],1.01-2.09)。在 1 年随访时,卒中复发(校正 HR,1.56;95% CI,1.09-2.24)、不良功能结局(校正 OR,1.62;95% CI,1.07-2.45)和复合血管事件(校正 HR,1.55;95% CI,1.09-2.20)也观察到类似的增加。在非糖尿病患者中,GA 与不良功能结局之间的相关性更为明显(校正 OR,1.62;95% CI,1.05-2.50)。将 GA 纳入常规模型可略微改善对不良功能结局的预测(1 年时净重新分类改善 [NRI]:12.30%)。

结论

本研究表明,血清中 GA 水平升高与缺血性卒中和 TIA 患者的卒中不良结局相关,包括卒中复发、不良功能结局和复合血管事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8387/11391381/dbea9b7fda89/JDB-16-e13600-g001.jpg

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