Wang Jiayin, Wu Shukai, Chen Jiani, Huang Jinzhong, Zhang Dankui
Department of Neurosurgery, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Front Neurol. 2025 Apr 15;16:1555328. doi: 10.3389/fneur.2025.1555328. eCollection 2025.
BACKGROUND: Post-traumatic epilepsy (PTE) is a common complication following traumatic brain injury (TBI). Early PTE refers to the appearance of seizure symptoms within 7 days of the injury. The glucose-to-potassium ratio (GPR) has emerged as a potential biomarker for predicting Early PTE risk. This study aimed to evaluate the association between GPR and the risk of Early PTE, and to assess the predictive value of GPR through various analyses. METHODS: A total of 2,049 TBI patients were included in the analysis, with the GPR evaluated both as a continuous and categorical variable. Logistic regression, trend tests, and Kaplan-Meier (KM) curve analyses were performed to assess the relationship between GPR and Early PTE. Subgroup analyses were conducted to explore potential effect modifiers, and restricted cubic spline (RCS) analyses were used to examine non-linear associations. Adjustments were made for demographic, clinical, and biochemical factors. RESULTS: The GPR demonstrated a significant non-linear association with Early PTE risk, with a turning point at GPR = 2.835. Patients with a GPR > 2.835 exhibited a higher risk of epilepsy, as indicated by KM curve analysis ( < 0.0001). Logistic regression analysis revealed that GPR was an independent predictor of Early PTE in both unadjusted and adjusted models. In the fully adjusted model, GPR remained significantly associated with early epilepsy (OR: 1.499, 95% CI: 1.188-1.891, < 0.001). Subgroup analyses identified gender, hypertension, and diabetes as significant effect modifiers. Trend tests revealed a dose-response relationship between GPR quartiles and epilepsy risk, with the highest quartile showing a significantly higher risk in both unadjusted and partially adjusted models ( = 0.017). CONCLUSIONS: The GPR is a robust and independent predictor of Early PTE, with higher GPR levels strongly associated with an increased risk of epilepsy. The non-linear relationship and variations across subgroups underscore the clinical utility of GPR in risk stratification and personalized management of TBI patients.
背景：创伤后癫痫（PTE）是创伤性脑损伤（TBI）后的常见并发症。早期PTE是指在损伤后7天内出现癫痫症状。葡萄糖与钾比值（GPR）已成为预测早期PTE风险的潜在生物标志物。本研究旨在评估GPR与早期PTE风险之间的关联，并通过各种分析评估GPR的预测价值。 方法：共有2049例TBI患者纳入分析，GPR作为连续变量和分类变量进行评估。进行逻辑回归、趋势检验和Kaplan-Meier（KM）曲线分析，以评估GPR与早期PTE之间的关系。进行亚组分析以探索潜在的效应修饰因素，并使用受限立方样条（RCS）分析来检验非线性关联。对人口统计学、临床和生化因素进行了调整。 结果：GPR与早期PTE风险呈显著非线性关联，转折点为GPR = 2.835。KM曲线分析表明，GPR>2.835的患者癫痫风险更高（<0.0001）。逻辑回归分析显示，在未调整和调整模型中，GPR都是早期PTE的独立预测因素。在完全调整模型中，GPR与早期癫痫仍显著相关（OR：1.499，95%CI：1.188-1.891，<0.001）。亚组分析确定性别、高血压和糖尿病为显著的效应修饰因素。趋势检验显示GPR四分位数与癫痫风险之间存在剂量反应关系，最高四分位数在未调整和部分调整模型中均显示出显著更高的风险（=0.017）。 结论：GPR是早期PTE的有力且独立的预测因素，GPR水平越高，癫痫风险增加的相关性越强。非线性关系和亚组间差异强调了GPR在TBI患者风险分层和个性化管理中的临床应用价值。
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