C反应蛋白-甘油三酯葡萄糖指数可预测高血压人群的卒中发生率：一项全国队列研究

C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study.

作者信息

Tang Songyuan, Wang Han, Li Kunwei, Chen Yaqing, Zheng Qiaoqi, Meng Jingjing, Chen Xin

机构信息

School of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.

Department of Cardiology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.

出版信息

Diabetol Metab Syndr. 2024 Nov 21;16(1):277. doi: 10.1186/s13098-024-01529-z.

BACKGROUND

Both the triglyceride-glucose (TyG) index, a predictor of insulin resistance (IR), and inflammation are risk factors for stroke in hypertensive patients. However, only a handful of studies have coupled the TyG index and inflammation indices to predict stroke risk in hypertensive patients. The C-reactive protein-triglyceride-glucose index (CTI) is a novel marker that comprehensively assesses the severity of IR and inflammation. The present study explored the association between CTI and the risk of stroke in patients with hypertension.

METHODS

A total of 3,834 hypertensive patients without a history of stroke at baseline were recruited from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate Cox regression and restricted cubic spline (RCS) analyses were employed to assess the relationship between CTI and stroke risk in hypertensive patients. Furthermore, the Boruta algorithm was applied to evaluate the importance of CTI and construct prediction models to forecast the incidence of stroke in the study cohort.

RESULTS

After 7 years of follow-up, the incidence of stroke in hypertensive patients was 9.6% (368 cases). Multivariate Cox regression analysis revealed a 21% increase in stroke risk with an increase in each CTI unit (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.08-1.37). The top quartile group was 66% more likely to have a stroke than the bottom quartile group (HR = 1.66, 95% CI = 1.23-2.25). RCS analysis confirmed a linear relationship between CTI and stroke risk. The Boruta algorithm validated CTI as a crucial indicator of stroke risk. The Support Vector Machine (SVM) survival model exhibited the best predictive performance for stroke risk in hypertensive patients, with an area under the curve (AUC) of 0.956.

CONCLUSIONS

An increase in CTI levels is associated with a higher risk of stroke in hypertensive patients. This study suggests that CTI may emerge as a unique predictive marker for stroke risk.

背景

甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗（IR）的一个预测指标，炎症是高血压患者发生中风的危险因素。然而，仅有少数研究将TyG指数与炎症指标结合起来预测高血压患者的中风风险。C反应蛋白-甘油三酯-葡萄糖指数（CTI）是一种综合评估IR和炎症严重程度的新型标志物。本研究探讨了CTI与高血压患者中风风险之间的关联。

方法

从中国健康与养老追踪调查（CHARLS）中招募了3834例基线时无中风病史的高血压患者。采用多变量Cox回归和限制性立方样条（RCS）分析来评估CTI与高血压患者中风风险之间的关系。此外，应用博鲁塔算法评估CTI的重要性，并构建预测模型以预测研究队列中中风的发生率。

结果

经过7年的随访，高血压患者中风的发生率为9.6%（368例）。多变量Cox回归分析显示，CTI每增加一个单位，中风风险增加21%（风险比（HR）=1.21，95%置信区间（CI）=1.08-1.37）。最高四分位数组发生中风的可能性比最低四分位数组高66%（HR=1.66，95%CI=1.23-2.25）。RCS分析证实了CTI与中风风险之间存在线性关系。博鲁塔算法验证了CTI是中风风险的一个关键指标。支持向量机（SVM）生存模型对高血压患者中风风险的预测性能最佳，曲线下面积（AUC）为0.956。