Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke.
Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke.
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缺血性脑卒中患者甘油三酯葡萄糖指数与颈总动脉内膜中层厚度
DOI：
10.1186/s12933-022-01472-1
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发表时间：
2022-03-18
影响因子：
9.3
通讯作者：
Zhong C
中科院分区：
文献类型：
--
作者：
Miao M;Zhou G;Bao A;Sun Y;Du H;Song L;Cao Y;You S;Zhong C
最近报道甘油三酯葡萄糖（TyG）指数与心血管事件发生和复发的风险增加相关，而动脉粥样硬化是主要的推测机制。然而，关于 TyG 指数与动脉粥样硬化之间关系的数据，特别是在缺血性中风的情况下，很少。我们的目的是探讨TyG指数与缺血性脑卒中患者颈动脉粥样硬化之间的关系。共有 1523 名具有 TyG 指数和颈动脉影像数据的缺血性脑卒中患者纳入本次分析。 TyG指数计算为ln[空腹甘油三酯(mg/dL) × 空腹葡萄糖(mg/dL)/2]。颈动脉粥样硬化通过颈总动脉内膜中层厚度（cIMT）来测量，异常cIMT定义为平均cIMT和最大cIMT值 ≥ 1 mm。使用多变量逻辑回归模型和限制三次样条模型来评估TyG指数与异常cIMT之间的关系。分析了TyG指数模型的风险重分类和校准。 TyG 指数第 4 分位数与第 1 分位数的多变量调整比值比 (95% CI) 平均 cIMT 异常为 1.56 (1.06–2.28)，最大 cIMT 异常为 1.46 (1.02–2.08)。 TyG指数与异常平均cIMT（线性P = 0.005）和异常最大cIMT（线性P = 0.027）之间存在线性关系。此外，TyG 指数提供了超出既定风险因素的增量预测能力，表现为净重分类改进和综合辨别改进的增加（所有 P<0.05）。较高的 TyG 指数与 cIMT 测量的缺血性中风患者的颈动脉粥样硬化相关，这表明 TyG 可能是一种有前途的动脉粥样硬化标志物。
Triglyceride glucose (TyG) index was recently reported to be associated with an increased risk of the development and recurrence of cardiovascular events, and atherosclerosis is a main speculative mechanism. However, data on the relationship between TyG index and atherosclerosis, especially in the setting of ischemic stroke, is rare. We aimed to explore the association between TyG index and carotid atherosclerosis in patients with ischemic stroke. A total of 1523 ischemic stroke patients with TyG index and carotid artery imaging data were enrolled in this analysis. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Carotid atherosclerosis was measured by common carotid artery intima-media thickness (cIMT), and abnormal cIMT was defined as a mean cIMT and maximum cIMT value ≥ 1 mm. Multivariable logistic regression models and restricted cubic spline models were used to assess the relationships between TyG index and abnormal cIMT. Risk reclassification and calibration of models with TyG index were analyzed. The multivariable-adjusted odds ratios (95% CIs) in quartile 4 versus quartile 1 of TyG index were 1.56 (1.06–2.28) for abnormal mean cIMT and 1.46 (1.02–2.08) for abnormal maximum cIMT, respectively. There were linear relationships between TyG index and abnormal mean cIMT (P for linearity = 0.005) and abnormal maximum cIMT (P for linearity = 0.027). In addition, the TyG index provided incremental predictive capacity beyond established risk factors, shown by an increase in net reclassification improvement and integrated discrimination improvement (all P < 0.05). A higher TyG index was associated with carotid atherosclerosis measured by cIMT in patients with ischemic stroke, suggesting that TyG could be a promising atherosclerotic marker.
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11.1
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