国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Association of triglyceride-glucose index and stroke recurrence among nondiabetic patients with acute ischemic stroke

第一作者：Xiaomeng Yang,Guangyao Wang

通讯作者：Yongjun Wang,Yilong Wang

Insulin resistance Ischemic stroke Prognosis Triglyceride-glucose index stroke recurrence death

基本信息

2022-03-08

已发表文章

发表杂志：BMC Neurology

发表类型: Research Article

影响因子(IF): 2.903

PMID: 35260102 Pubmed原文链接 全文下载

主要研究背景及目的

Insulin resistance, measured by homeostasis model assessment–insulin resistance (HOMA-IR) index, was associated with an increased risk of stroke recurrence, death, and poor outcome in nondiabetic patients with acute ischemic stroke.[1] Previous studies showed triglyceride-glucose index (TyG index) could be useful as surrogate to identify insulin resistance in apparently healthy subjects.[2, 3] Some studies showed that TyG index was more independently associated with the presence of coronary artery atherosclerosis[4], carotid atherosclerosis[5] and the development of diabetes[6] than HOMA-IR. However, few studies have compared the effects of HOMA-IR and TyG index on predicting prognosis of nondiabetic patients with acute ischemic stroke. We aim to compare the effects of HOMA-IR and TyG index on predicting stroke recurrence and death in nondiabetic patients with ischemic stroke.

方法

Nondiabetic acute ischemic stroke patients from the ACROSS-China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry were included. TyG index was performed and classified into four groups by quartiles. The outcomes were stroke recurrence and death within 1 year. The association between TyG index and the risk of stroke recurrence and death were analyzed by Cox regression models. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prediction of TyG index and HOMA-IR for stroke recurrence and death. Delong test was used for comparing the differences between area under the curve (AUC) of TyG index and HOMA-IR.

结论

Elevated TyG index was associated with an increased risk of stroke recurrence and death. However, neither of TyG nor HOMA-IR can be a qualified predictor of stroke recurrence and death in nondiabetic acute ischemic stroke patients.

主要结果

Among the 1226 patients included, the median (interquartile range) of TyG index was 5.8 (5.5–6.2). Both the third and fourth quartiles of TyG index were associated with an increased risk of stroke recurrence (adjusted hazard ratio 2.04, 95% confidence interval 1.26–3.31; adjusted hazard ratio 1.86, 95% confidence interval 1.13–3.06). Patients with fourth quartiles of TyG index were associated with a higher mortality risk (adjusted hazard ratio, 2.91; 95% confidence interval, 1.62–2.53). Regarding stroke recurrence within 1 year, the AUC (95% confidence interval) of the ROC curve for the TyG index was similar to that of the HOMA-IR[0.56 (0.52–0.61) vs 0.57 (0.52–0.61); P = 0.93]. Regarding death within 1 year, the AUCs (95% confidence interval) of the ROC curve for the TyG index and HOMA-IR were 0.55 (0.50–0.61) and 0.59 (0.53–0.64), respectively (P = 0.32).