Nam Ki-Woong, Kwon Hyung-Min, Lee Yong-Seok
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea, 101 Daehak-ro, Jongno-gu, 03080.
Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Seoul, Korea.
Diabetol Metab Syndr. 2025 Apr 9;17(1):123. doi: 10.1186/s13098-025-01684-x.
Stroke due to large artery atherosclerosis (LAA-stroke) has a poor early prognosis despite appropriate medical treatment. Recently, various parameters reflecting pathological conditions such as insulin resistance or atherogenic dyslipidemia have been proposed using triglyceride (TG) and other biomarkers. In this study, we evaluated the association between TG andTG-related parameters and early neurological deterioration (END) in patients with acute LAA stroke.
We evaluated consecutive patients with acute LAA-stroke between January 2010 and December 2020. TG-related parameters were calculated using the following formulas: the atherogenic index of plasma (AIP) = log (TG level/high-density lipoprotein level) and TG-glucose (TyG) index = Ln (TG level x glucose level/2). END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score within the first 72 h of admission.
Six hundred and forty patients with acute LAA-stroke were evaluated. In multivariable analyses, AIP (adjusted odds ratio [aOR]: 1.93, 95% confidence interval: 1.32-2.82) was closely associated with END after adjustment for confounders. The TyG index (aOR: 2.22, 95% confidence interval: 1.51-3.27) also showed close association with END. The AIP and TyG index showed significant differences between the END and no END groups only in patients with LAA-stroke caused by intracranial atherosclerosis. In addition, AIP and TyG index were closely related to END only in patients with LAA-stroke caused by artery-to-artery embolism and branch atheromatous disease mechanisms.
We found that TG and TG-related parameters were associated with the occurrence of END in patients with acute LAA-stroke. This association appeared differently depending on the location or mechanism of the relevant vessel that caused LAA-stroke.
尽管接受了适当的药物治疗，但大动脉粥样硬化性卒中（LAA 卒中）的早期预后较差。最近，利用甘油三酯（TG）和其他生物标志物提出了各种反映病理状况的参数，如胰岛素抵抗或致动脉粥样硬化性血脂异常。在本研究中，我们评估了急性 LAA 卒中患者中 TG 及与 TG 相关的参数与早期神经功能恶化（END）之间的关联。
我们评估了 2010 年 1 月至 2020 年 12 月期间连续的急性 LAA 卒中患者。使用以下公式计算与 TG 相关的参数：血浆致动脉粥样硬化指数（AIP）=log（TG 水平/高密度脂蛋白水平），TG-葡萄糖（TyG）指数=Ln（TG 水平×葡萄糖水平/2）。END 定义为入院后 72 小时内美国国立卫生研究院卒中量表（NIHSS）总分增加≥2 分或运动 NIHSS 评分增加≥1 分。
对 640 例急性 LAA 卒中患者进行了评估。在多变量分析中，校正混杂因素后，AIP（校正比值比[aOR]：1.93，95%置信区间：1.32-2.82）与 END 密切相关。TyG 指数（aOR：2.22，95%置信区间：1.51-3.27）也显示与 END 密切相关。仅在颅内动脉粥样硬化导致的 LAA 卒中患者中，AIP 和 TyG 指数在 END 组和无 END 组之间存在显著差异。此外，仅在动脉到动脉栓塞和分支动脉粥样硬化疾病机制导致的 LAA 卒中患者中，AIP 和 TyG 指数与 END 密切相关。
我们发现 TG 及与 TG 相关的参数与急性 LAA 卒中患者 END 的发生有关。这种关联因导致 LAA 卒中的相关血管的位置或机制不同而有所差异。
