Li Jie, Ma Wenyang, Tang Wuzhuang, Yang Kaixuan, Gu Hongqiu, Shi Junfeng, Chen Feng, Xu Chenhan, Gu Shiyuan, Wang Yongjun
Department of Neurology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, People's Republic of China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Int J Gen Med. 2024 Dec 5;17:5825-5836. doi: 10.2147/IJGM.S467156. eCollection 2024.
Raised serum glucose-phosphate ratio on admission is associated with severity and poor outcome of aneurysmal subarachnoid hemorrhage and severe traumatic brain injury. However, its role in acute ischemic stroke (AIS) remains still unknown. Therefore, this prospective study aimed to investigate the association between admission serum glucose-phosphate ratio and the severity and 1-year clinical outcome of AIS.
All the patients with AIS were enrolled from the Third China National Stroke Registry III. Participants were classified into four groups according to quartiles of admission serum glucose-phosphate ratio levels. Multiple regression models and restricted cubic splines were performed to evaluate the association between serum glucose-phosphate ratio and the severity and 1-year outcome of patients with AIS.
Among the 5,541 participants, the mean age was 62.3 years, and 69.4% patients were men. As the quartiles of admission serum glucose-phosphate ratio increased, the median NIHSS score raised, the percentage of moderate and severe stroke elevated, and rates of poor functional outcomes and recurrent stroke raised at one-year follow-up. After adjusting conventional risk factors, the highest admission serum glucose-phosphate ratio-level quartile group showed an association of poor functional outcome and stroke recurrence [OR (95% CI): 1.67 (1.28, 2.17) and HR (95% CI): 1.44 (1.08, 1.92), respectively], relative to the lowest group. Restricted cubic splines showed no significant nonlinear relationship between serum glucose-phosphate ratio and adverse outcomes of AIS.
Admission serum glucose-phosphate ratio may be a potential blood biomarker for reflecting stroke severity, predicting poor functional outcomes, and stroke recurrence.
入院时血清葡萄糖 - 磷酸盐比值升高与动脉瘤性蛛网膜下腔出血及重型颅脑损伤的严重程度和不良预后相关。然而，其在急性缺血性卒中（AIS）中的作用仍不清楚。因此，本前瞻性研究旨在探讨入院时血清葡萄糖 - 磷酸盐比值与AIS严重程度及1年临床结局之间的关联。
所有AIS患者均来自中国国家卒中登记库Ⅲ。根据入院时血清葡萄糖 - 磷酸盐比值水平的四分位数将参与者分为四组。采用多元回归模型和受限立方样条来评估血清葡萄糖 - 磷酸盐比值与AIS患者严重程度及1年结局之间的关联。
在5541名参与者中，平均年龄为62.3岁，69.4%为男性。随着入院时血清葡萄糖 - 磷酸盐比值四分位数的增加，美国国立卫生研究院卒中量表（NIHSS）中位数评分升高，中度和重度卒中百分比升高，1年随访时功能预后不良和卒中复发率升高。在调整传统危险因素后，与最低组相比，最高入院血清葡萄糖 - 磷酸盐比值水平四分位数组显示功能预后不良和卒中复发的关联[比值比（95%可信区间）：分别为1.67（1.28，2.17）和风险比（95%可信区间）：1.44（1.08，1.92）]。受限立方样条显示血清葡萄糖 - 磷酸盐比值与AIS不良结局之间无显著非线性关系。
入院时血清葡萄糖 - 磷酸盐比值可能是反映卒中严重程度、预测功能预后不良及卒中复发的潜在血液生物标志物。
