甘油三酯-葡萄糖指数与颅内动脉粥样硬化性狭窄的相关性

Correlation of triglycride-glucose index and atherosclerotic stenosis in intracranial arteries

目的探讨甘油三酯葡萄糖(triglycride-glucose,TyG)指数与急性缺血性脑卒中(acute ischemic stroke,AIS)患者颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)之间的关联,并评估TyG指数在预测AIS患者发生ICAS中的应用价值。方法选取2021年12月至2023年12月山东省立医院神经内科住院AIS患者380例。根据数字减影血管造影(digital subtraction angiography,DSA)结果分为对照组(n=116)和狭窄组(n=264),收集两组病史、身高、体质量、血压等基本资料,检测甘油三酯(triglyceride,TG)、空腹血糖(fasting plasma glucose,FPG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-c)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-c)、总胆固醇(total cholesterol,TC)等指标。采用多因素Logistic回归分析AIS患者发生ICAS的危险因素。采用受试者工作特征(receiver operator characteristic,ROC)曲线评估TyG指数对AIS患者发生ICAS的预测价值。结果狭窄组高血压病史、糖尿病史、收缩压、舒张压、体质量指数(body mass index,BMI)、TG、FPG、TyG指数较对照组升高,差异有统计学意义(P<0.05)。AIS患者ICAS的检出率随TyG指数三分位数增加而升高(P<0.05)。Spearman相关性分析显示,AIS患者ICAS与高血压史、糖尿病史、收缩压、舒张压、BMI、FPG、TG、TyG指数呈正相关(r分别为0.189、0.273、0.157、0.175、0.142、0.400、0.290、0.431,P<0.05),与HDL-c呈负相关(r为-0.248,P<0.05)。二分类Logistic回归分析显示,TyG指数是ICAS的独立影响因素(OR=10.829,95%CI:5.179~22.641,P<0.05),HDL-c(OR=0.269,95%CI:0.141~0.514,P<0.05)是ICAS的保护因素。ROC曲线显示,对于预测AIS患者ICAS,TyG指数的曲线下面积为0.777(95%CI:0.723~0.830,P<0.05),当TyG指数取最佳截断值8.625时,对应的灵敏度为0.811,特异度为0.629。结论TyG指数与AIS患者ICAS相关,并且高TyG指数可能是AIS患者ICAS的独立危险因素。TyG指数对AIS患者ICAS具有一定的预测价值。

Objective To investigate the association between the triglyceride-glucose(TyG)index and intracranial atherosclerotic stenosis(ICAS)in patients with acute ischaemic stroke(AIS).and to assess the value of the application of TyG index in predicting the occurrence of ICAS in AIS patients.Methods A total of 380 patients with AIS admitted to the Department of Neurology,Shandong Provincial Hospital from December 2021 to December 2023 were selected.They were divided into control group(n=116)and stenosis group(n=264)according to the results of digital subtraction angiography(DSA).Baseline data such as medical history,height,body weight,blood pressure,etc.,were collected from both groups.Indices such as triglycerides(TG),fasting plasma glucose(FPG),low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol(HDL-c)and total cholesterol(TC)were measured.Multifactorial Logistic regression was used to analyse the risk factors for ICAS in AIS patients.The predictive value of the TyG index for the occurrence of ICAS in patients with AIS was assessed using the receiver operating characteristic(ROC)curve.Results History of hypertension,history of diabetes mellitus,systolic blood pressure,diastolic blood pressure,BMl,TG,FPG and TyG index were increased in the stenosis group compared with the control group,and the difference was statistically significant(P<0.05).The detection rate of ICAS in patients with AIS increased with the increase in tertile of TyG index(P<0.05).Spearman's correlation analysis showed that ICAS and history of hypertension,history of diabetes mellitus,systolic blood pressure,diastolic blood pressure,BMl,FPG,TG and TyG index were positively correlated(r values were 0.189,0.273,0.157,0.175,0.142,0.400,0.290 and 0.431,respectively,P<0.05),while ICAS and HDL-c was negatively correlated(r=-0.248,P<0.05).Two-category Logistic regression analysis showed that TyG index had an independent influence on ICAS(OR=10.829,95%CI:5.179-22.641,P<0.05),and HDL-c(OR=0.269,95%CI:0.141-0.514,P<0.05)was a protective factor against ICAS.The ROC curve showed that,the area under the curve of TyG index was 0.777(95%CI:0.723-0.830,P<0.05),which corresponded to a sensitivity of 0.811 and a specificity of 0.629 when the optimal cut-off value of TyG index was 8.625.Conclusion TyG index is associated with ICAS in AIS patients,and high TyG index may be an independent risk factor for ICAS in AIS patients.TyG index has some predictive value for ICAS in AIS patients.