心脏代谢指数与中风发病率之间的关联：一项中国全国性前瞻性队列研究。

Association between cardiometabolic index and the incidence of stroke: a prospective nationwide cohort study in China.

作者信息

Huang Xingjie, Wen Song, Huang Yuqing, Zhang Bin, Xia Zhonghua, Huang Zehan

机构信息

Department of Cardiology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi 541000 China.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 106 Zhongshan 2nd Road, Yuexiu, Guangzhou, Guangdong 510080 China.

出版信息

J Diabetes Metab Disord. 2024 Dec 27;24(1):26. doi: 10.1007/s40200-024-01530-3. eCollection 2025 Jun.

DOI:10.1007/s40200-024-01530-3

PMID:39735172

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11680538/

Abstract

OBJECTIVES

Cardiometabolic index (CMI), based on triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and waist-to-height ratio (WHtR), has been recognized as a novel and practical marker for the assessment of cardiometabolic risk. However, the relationship between CMI and the incidence of stroke remains to be elucidated. This investigation aimed to explore the association between CMI and stroke incidence.

METHODS

The investigation included 6,633 individuals aged over 45 years from the China Health and Retirement Longitudinal Study. Logistic regressions and restricted cubic spline regression were uitilized to determine the relationship between CMI and the incidence of stroke. Weighted quantile sum regression was used to offer a comprehensive explanation of the CMI by calculating the weights of triglyceride-glucose (TG), high-density lipoprotein cholesterol (HDL-C), weight, and height.

RESULTS

During the 9-year follow-up, 827 (12%) incident stroke participants were identified. With CMI as a continuous variable, the OR (95% CI) for the risk of incident stroke was 1.09 (1.01-1.19) ( = 0.047) after adjusting for potential confounders, indicating a significant link between increased CMI and an elevated incidence of stroke. Additionally, when CMI was categorized into quartiles, compared to the first quartile, the incident stroke was significantly higher in the fourth quartile (OR 1.57, 95%CI 1.22-2.04, <0.001). The association between CMI and stroke incidence was nonlinear ( =0.002, = 0.006). TG emerged as the primary contributor when the weights were assigned to the constituent elements of the CMI (weight = 0.645).

CONCLUSIONS

The CMI was independently associated with stroke incidence in middle-aged and elderly Chinese populations. Long-term CMI monitoring is of great importance for early identification and prevention of stroke, with significant implications for clinical practice.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-024-01530-3.

摘要

目的

基于甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）的比值以及腰高比（WHtR）的心脏代谢指数（CMI），已被公认为是评估心脏代谢风险的一种新颖且实用的标志物。然而，CMI与中风发病率之间的关系仍有待阐明。本研究旨在探讨CMI与中风发病率之间的关联。

方法

本研究纳入了来自中国健康与养老追踪调查的6633名45岁以上的个体。采用逻辑回归和限制立方样条回归来确定CMI与中风发病率之间的关系。通过计算甘油三酯-葡萄糖（TG）、高密度脂蛋白胆固醇（HDL-C）、体重和身高的权重，使用加权分位数和回归对CMI进行综合解释。

结果

在9年的随访期间，共识别出827名（12%）中风发病参与者。将CMI作为连续变量，在调整潜在混杂因素后，中风发病风险的OR（95%CI）为1.09（1.01 - 1.19）（P = 0.047），表明CMI升高与中风发病率升高之间存在显著关联。此外，当将CMI分为四分位数时，与第一四分位数相比，第四四分位数的中风发病率显著更高（OR 1.57，95%CI 1.22 - 2.04，P < 0.001）。CMI与中风发病率之间的关联是非线性的（P = 0.002，P = 0.006）。当对CMI的构成要素赋予权重时，TG成为主要贡献因素（权重 = 0.645）。