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中风与估计葡萄糖处置率的关系:两项前瞻性队列研究的结果。

Relationship between stroke and estimated glucose disposal rate: results from two prospective cohort studies.

机构信息

Chengdu University of Traditional Chinese Medicine, No. 37 Shi-Er-Qiao Road, Chengdu, Sichuan Province, 610072, People's Republic of China.

Southwest Medical University, No.319 Zhongshan Road, Luzhou, Sichuan Province, 646000, People's Republic of China.

出版信息

Lipids Health Dis. 2024 Nov 28;23(1):392. doi: 10.1186/s12944-024-02385-6.

Abstract

BACKGROUND

Insulin resistance (IR) is a recognized contributor to stroke association, and the estimated glucose disposal rate (eGDR) is a dependable indicator of IR. However, the specific connections between eGDR, stroke prevalence, and overall mortality have not been thoroughly investigated. This study aimed to examine how eGDR correlates with stroke and overall death rate.

METHODS

The study leveraged information from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. To unravel the data, the team utilized logistic regression, cox proportional hazards models, and restricted cubic splines (RCS) Sensitivity analyses excluded participants with a stroke history within the previous two years. Results were validated through analysis of the China Health and Retirement Longitudinal Study (CHARLS).

RESULTS

A higher eGDR is like a protective shield against strokes, with those in the top eGDR quartile exhibited a 60% reduction in stroke association (OR = 0.40, 95% CI, 0.22-0.73, P = 0.003). Additionally, a higher eGDR correlates with a lower overall death rate (HR = 0.71, 95% CI, 0.52-0.98, P = 0.037), particularly in individuals without a history of stroke. RCS analysis demonstrated that eGDR's influence on stroke association follows a non-linear pattern. Subgroup analysis revealed that the protective effect of eGDR was stronger in non-diabetic and non-hypertensive individuals.

CONCLUSION

eGDR is inversely related to both stroke association and mortality, affirming its utility as a predictive marker of stroke.

摘要

背景

胰岛素抵抗(IR)是公认的中风发病因素,估计葡萄糖处置率(eGDR)是 IR 的可靠指标。然而,eGDR、中风患病率和总死亡率之间的具体联系尚未得到充分研究。本研究旨在探讨 eGDR 与中风和总死亡率的相关性。

方法

本研究利用了 2007 年至 2016 年期间国家健康与营养调查(NHANES)的数据。为了解析数据,研究团队使用了逻辑回归、Cox 比例风险模型和限制性立方样条(RCS)。敏感性分析排除了在过去两年内有中风病史的参与者。研究结果还通过对中国健康与养老追踪调查(CHARLS)的分析进行了验证。

结果

较高的 eGDR 对中风具有保护作用,处于 eGDR 最高四分位数的人群中风发病风险降低了 60%(OR=0.40,95%CI,0.22-0.73,P=0.003)。此外,较高的 eGDR 与较低的总死亡率相关(HR=0.71,95%CI,0.52-0.98,P=0.037),尤其是在没有中风病史的人群中。RCS 分析表明,eGDR 对中风发病的影响呈非线性模式。亚组分析显示,eGDR 在非糖尿病和非高血压人群中的保护作用更强。

结论

eGDR 与中风发病和死亡率呈负相关,证实了其作为中风预测标志物的效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ee0/11603670/249900e6785b/12944_2024_2385_Fig1_HTML.jpg

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