Yan Xiaohui, Wu Dan, Xu Xinyu, Zhang Aimei, Liao Junqi, He Qiuhua, Song Fantao, Liu Yan, Chen Zhaoyao, Wu Minghua, Li Li, Li Wenlei
Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, 210029, Nanjing, China.
Heliyon. 2024 Aug 30;10(17):e36911. doi: 10.1016/j.heliyon.2024.e36911. eCollection 2024 Sep 15.
Recent studies have shown that the serum glucose-potassium ratio (GPR) upon admission is correlated with the prognosis of cerebrovascular disorders. Herein, we investigated the relationship between GPR and 90-day functional outcomes in patients with acute ischaemic stroke (AIS).
Clinical data were collected from patients with AIS registered at the Stroke Center of Jiangsu Provincial Hospital of Chinese Medicine. The relationship between the GPR and 90-day outcomes was analysed using univariate and multivariate logistic regression analyses, linear regression analyses, and subgroup analyses.
A total of 1826 patients met the enrolment requirements. The number of patients with a glucose-to-potassium ratio greater than the median value increased proportionally with increases in the NIHSS at admission and the 90-day modified Rankin scale (mRS). Univariate logistic regression analysis revealed a significant relationship between GPR and 90-day negative prognosis (OR 1.34 [95%Cl, 1.17-1.54], P < 0.001). After adjusting for all confounding variables, the relationship between GPR and 90-day adverse prognosis was shown to be nonlinearly U-shaped, with an inflection point of the curve for GPR of 1.347. Two linear regression analyses were performed on the basis of the inflection points of the curves. The results of this analysis revealed a negative correlation between GPR and 90-day adverse outcomes at GPR<1.347 (OR 0.86 [95%CI,0.09-7.86], P = 0.897), as well as a positive correlation between GPR and 90-day adverse outcomes at GPR≥1.347 (OR1.52 [95%CI, 1.19-1.93], P = 0.001). Subgroup analyses verified that the association between GPR and 90-day poor prognosis still existed, regardless of whether the patient had a history of diabetes mellitus (DM). (with DM: OR 1.39 [ 95%Cl, 1.05-1.83], P = 0.001); without DM: OR 0.93 [ 95%Cl,0.56-1.55], P = 0.016).
GPR significantly correlated with poor prognosis at 90-days in patients with AIS. Early intervention and control of GPR are expected to enhance functional outcomes in patients with AIS.
最近的研究表明，入院时的血糖-钾比值（GPR）与脑血管疾病的预后相关。在此，我们研究了急性缺血性卒中（AIS）患者中GPR与90天功能结局之间的关系。
收集江苏省中医院卒中中心登记的AIS患者的临床资料。采用单因素和多因素逻辑回归分析、线性回归分析及亚组分析来分析GPR与90天结局之间的关系。
共有1826例患者符合纳入标准。血糖-钾比值大于中位数的患者数量随着入院时美国国立卫生研究院卒中量表（NIHSS）评分及90天改良Rankin量表（mRS）评分的增加而成比例增加。单因素逻辑回归分析显示GPR与90天不良预后之间存在显著关系（比值比[OR]1.34[95%置信区间（Cl），1.17 - 1.54]，P < 0.001）。在对所有混杂变量进行校正后，GPR与90天不良预后之间的关系呈非线性U形，GPR曲线的拐点为1.347。基于曲线拐点进行了两项线性回归分析。该分析结果显示，在GPR<1.347时，GPR与90天不良结局呈负相关（OR 0.86[95%CI，0.09 - 7.86]，P = 0.897），而在GPR≥1.347时，GPR与90天不良结局呈正相关（OR1.52[95%CI，1.19 - 1.93]，P = 0.001）。亚组分析证实，无论患者是否有糖尿病（DM）病史，GPR与90天预后不良之间的关联仍然存在。（有DM：OR 1.39[95%Cl，1.05 - 1.83]，P = 0.001）；无DM：OR 0.93[95%Cl，0.56 - 1.55]，P = 0.016）。
AIS患者中GPR与90天不良预后显著相关。早期干预和控制GPR有望改善AIS患者的功能结局。
