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
A novel nutritional index and adverse outcomes in ischemic stroke: Results from the third China National Stroke Registry
第一作者：Guitao Zhang
基本信息
- 负责人：Guitao Zhang
- 数据来源： CNSR-Ⅲ
- 论文编号：CNSR-Ⅲ20210138
- 发表时间：2022-03-03
2022-03-03
已发表文章
发表杂志：Nutrition Metabolism and Cardiovascular Diseases
发表类型: Original Contributions
影响因子(IF): 4.666
PMID: 35351344 Pubmed原文链接 全文下载
主要研究背景及目的
Triglycerides, cholesterol, body weight index (TCBI), a novel simply calculated nutritional index which including serum total cholesterol (TC) and triglycerides (TG) and body weight (BW). In previous studies, TCBI had been used not only as a nutritional index but also as a prognostic indicator in patients with coronary artery disease, acute decompensated heart failure, and hemodynamically unstable patients in the intensive care unit. But there are still few studies of the TCBI applied to ischemic stroke patients. In this study, we investigated the association between the lower TCBI level and adverse clinical outcomes including poor functional outcome and mortality based on data from the Third China National Stroke Registry (CNSR-III), a nationwide, large-scale, prospective cohort of patients with ischemic stroke in China. Further, we explored the risk of adverse outcomes along with the TCBI using restricted cubic splines.
方法
Study was based on the CNSR-Ⅲ. Patients’ characteristics were reported as percentages for categorical variables and median with interquartile range (IQR) or mean with standard deviation (SD) for continuous variables. Statistical comparisons were performed with the chi-square test or Fisher’s exact test, one-way analysis of variance or Kruskal-Wallis H-test, as appropriate. The survival curves for all-cause death were presented using the Kaplan–Meier method and compared between four groups by log-rank test. Univariable and multivariable analyses with logistic or Cox regression were used to determine the association between TCBI and adverse outcomes. Variables were adjusted including age, sex, initial NIHSS score, premorbid mRS, TOAST classification, previous medical history of stroke, hypertension, coronary heart disease, dyslipidemia, diabetes, cigarette smoking, alcohol consumption, and statin therapy, antiplatelet therapy. We also used restricted cubic splines to explore the association of TCBI (continuous variable) with the adverse outcomes, adjusting for potential confounding factors. All tests were two-tailed, and P < 0.05 was considered statistically significant. All analyses were conducted using R software version 4.0.2 and SAS version 9.4 statistical software (SAS Institute Inc., Cary, North Carolina, USA).
结论
The novel TCBI was associated with short- and long-term adverse outcomes in AIS. Thus, it may be useful for predicting adverse outcomes in patients with AIS.
主要结果
9,708 patients were finally included. At the 1-year follow-up, 1,323 patients (13.6%) experienced death or major disability. The adjusted odds ratios / hazard ratios, and 95% confidence intervals of the lowest quartile at 1-year were 1.47 (1.22–1.78) for the poor functional outcomes, 1.46 (1.18–1.81) for major disability, and 1.34 (0.94–1.86) for all-cause death at 1-year. Kaplan–Meier analysis demonstrated an inverse relationship between all-cause death and the TCBI (log-rank p < 0.05). An approximately L-shaped relationship between TCBI levels and poor functional outcomes and major disability was observed at 1-year.