A novel nutritional index and adverse outcomes in ischemic stroke: Results from the third China National Stroke Registry
First author:Guitao Zhang
Corresponding author:Yongjun Wang,Gaifen Liu
2022-03-03
Journal:Nutrition Metabolism and Cardiovascular Diseases
Publication type: Original Contributions
IF(IF): 4.666
PMID: 35351344 Link To Pubmed Full text Download
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.
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).
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.
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.