三酰甘油-葡萄糖指数与急性缺血性卒中神经功能缺损的相关性分析

doi:10.3969/j.issn.1673-5765.2022.03.006

摘要/Abstract

摘要：

目的探讨三酰甘油-葡萄糖（triglyceride-glucose，TyG）指数与急性缺血性卒中（acute ischemic stroke，AIS）患者神经功能缺损的相关性。

方法回顾性分析2021年1-5月于深圳市人民医院神经内科住院治疗的AIS患者的临床资料。采用 NIHSS评估AIS后神经功能缺损严重程度，根据入院时NIHSS，将入组患者分为无神经功能缺损组（0 分）、轻度神经功能缺损组（1～4分）和中重度神经功能缺损组（＞4分），比较3组患者的临床特点。应用ROC曲线评估TyG指数对神经功能缺损严重程度的预测价值，根据TyG指数最佳截断值将患者分成低TyG指数组和高TyG指数组，采用二元logistic回归分析TyG指数与AIS后神经功能缺损严重程度的关系。

结果研究共入组177例AIS患者，其中无神经功能缺损组43例、轻度神经功能缺损组85例，中重度神经功能缺损组49例。3组的糖尿病和高脂血症比例，糖化血红蛋白（glycated hemoglobin，HbA1c）、空腹血糖（fasting plasma glucose，FPG）、TG、TC水平及TyG指数等指标的差异有统计学意义。在入组的AIS患者中，TyG指数与糖尿病、高脂血症、HbA1c水平、FPG水平、TG水平、TC水平、LDL-C水平及入院NIHSS呈正相关，与年龄、HDL-C水平呈负相关。TyG指数预测神经功能缺损（NIHSS≥1分）的 AUC为0.70（95%CI 0.62～0.79，P＜0.001），最佳截断值为8.55，敏感度为69.4%，特异度为62.8%。logistic回归显示，在AIS患者中，TyG指数每增加1，发生神经功能缺损的风险性增加2.03倍（OR 3.03， 95%CI 1.79～6.11，P＜0.001），发生中重度神经功能缺损的风险性增加4.72倍（OR 5.72，95%CI 3.12～10.45，P＜0.001）。

结论 TyG指数与AIS患者神经功能缺损严重程度正相关，TyG指数升高是AIS患者神经功能缺损严重程度的独立预测因素。

文章导读： 本研究提示TyG指数与AIS患者是否出现神经功能缺损及神经功能缺损的严重程度有关，是潜在且简单易获得的预测AIS神经功能缺损程度的临床指标。

关键词: 三酰甘油-葡萄糖指数; 急性缺血性卒中; 神经功能缺损; 胰岛素抵抗

Abstract:

Objective To investigate the correlation between triglyceride - glucose (TyG) index and neurological function impairment after acute ischemic stroke (AIS).

Methods The clinical data of AIS patients who were admitted to Department of Neurology, Shenzhen People's Hospital from January to May 2021 were retrospectively analyzed. Based on NIHSS score at admission, the patients were divided into three groups: without neurological deficit group (NIHSS 0), mild neurological deficit group (NIHSS 1-4) and moderate to severe neurological deficit group (NIHSS >4). ROC curve was used to evaluate the predictive value of TyG index for the severity of neurological deficits. According to the optimal cut-off value of TyG index, the patients were divided into low and high TyG index groups. The correlation between TyG index and severity of neurological deficits after AIS was analyzed using logistic regression.

Results A total of 177 AIS patients were included in this study, and there were 43 cases without neurological deficit, 85 cases with mild neurological deficit and 49 cases with moderate to severe neurological deficit. Among the three groups, there were statistical differences in the percentage of diabetes mellitus and hyperlipidemia, level of HbA1c, FPG, TG, TC, TyG index and NIHSS score (P <0.05). TyG index was positively correlated with diabetes mellitus, hyperlipidemia, level of HbA1c, FPG, TG, TC and LDL-C and NIHSS at admission, and negatively correlated with age and HDL-C level (P <0.05). The AUC of TyG index for neurological deficits was 0.70 (95%CI 0.62- 0.79, P <0.001), and the optimal cut-off value was 8.55, with the sensitivity of 69.4%, and specificity of 62.8%. Logistic regression analysis showed that the risk of neurological deficits increased by 2.03 times (OR 3.03, 95%CI 1.79-6.11, P <0.001), and the risk of moderate to severe neurological deficits increased by 4.72 times (OR 5.72, 95%CI 3.12-10.45, P <0.001), with 1 increase of TyG index in AIS patients.

Conclusions TyG index was positively correlated with the severity of neurological deficits in AIS patients.

Key words: Triglyceride-glucose index; Neurological impairment; Acute ischemic stroke; Insulin resistance

黄妍, 付学军, 史会杰, 邹良玉. 三酰甘油-葡萄糖指数与急性缺血性卒中神经功能缺损的相关性分析[J]. 中国卒中杂志, 2022, 17(03): 251-257.

HUANG Yan, FU Xuejun, SHI Huijie, ZOU Liangyu. Correlation between Triglyceride-Glucose Index and Neurological Function Impairment after Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2022, 17(03): 251-257.

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