血浆致动脉粥样硬化指数对新发缺血性脑卒中的影响
Impact of the atherogenic index of plasma on new-onset ischemic stroke
吕素洁 1吴寿岭 1李金锋 1朱辰蕊 1王艳丽 2季春鹏1
作者信息
- 1. 063000 唐山,开滦总医院心内科
- 2. 063000 唐山,开滦总医院重症医学科
- 折叠
摘要
目的 探讨基线血浆致动脉粥样硬化指数(AIP)对新发缺血性脑卒中的影响.方法 采用前瞻性队列研究方法,选取2006年7月至2007年10月参加健康体检、既往无脑卒中病史、资料完整的97 680名开滦集团公司职工作为观察队列,随访至2020年12月31日,以新发缺血性脑卒中作为终点事件.根据基线AIP三分位数将研究人群分为3组,T1组32 574名(AIP＜-0.18)、T2组33 033名(-0.18≤AIP＜0.06)和T3组32 073名(AIP≥0.06).根据寿命表法计算各组缺血性脑卒中的累积发病率,并采用log-rank检验比较组间差异.采用多因素Cox比例风险回归模型分析基线AIP对新发缺血性脑卒中的影响.结果 在平均随访(13.7±1.7)年后,共有5 822例研究对象发生缺血性脑卒中.随基线AIP三分位数分组递增,新发缺血性脑卒中的累积发病率呈递增趋势,T1、T2和T3组分别为4.8％、5.8％和7.2％(x2=143.97,P＜0.001).在校正相关混杂因素后,多因素Cox回归分析结果显示,基线AIP每增加一个标准差(0.29),新发缺血性脑卒中的风险增加36％(HR=1.36,95％CI:1.23～1.50,P＜0.001);与T1组比较,T2和T3组新发缺血性脑卒中的风险分别增加12％(HR=1.12,95％CI:1.04～1.20,P＜0.001)和 26％(HR=1.26,95％CI:1.18～1.36,P＜0.001).进一步分析发现,在随访至第2年时,在校正相关混杂因素后,不同基线AIP三分位数分组之间新发缺血性脑卒中的风险差异并无统计学意义;而在随访至第4年时,T3组新发缺血性脑卒中风险显著高于T1组(HR=1.24,95％CI:1.06～1.46,P=0.009).结论 AIP增加是新发缺血性脑卒中的独立危险因素,而且此种致病效应可能在早期(2～4年)即开始显现.
Abstract
Objective To investigate the impact of baseline atherogenic index of plasma(AIP)on new-onset ischemic stroke.Methods This was a prospective cohort study.A total of 97 680 employees without previous stroke participated in the health examination from 2006 to 2007 were enrolled and followed until December 31,2020.The primary endpoint was new-onset ischemic stroke.The study population was divided into three groups according to tertiles of the baseline AIP(T1 group:AIP＜-0.18;T2 group:-0.18≤ AIP＜0.06;T3 group:AIP ≥ 0.06).The cumulative incidence of new-onset ischemic stroke was calculated using the life-table method and compared using the Log-rank test.Multivariate cox regression models were used to analyze the effect of baseline AIP on new-onset ischemic stroke.Results A total of 5 822 cases of new-onset ischemic stroke occurred after a mean follow-up of 13.7±1.7 years.The cumulative incidence of new-onset ischemic stroke increased with the baseline AIP tertiles,which was 4.8％,5.8％and 7.2％,respectively(P＜0.001).After adjusting for confounders,the risk of new-onset ischemic stroke increased by 36％(HR=1.36,95％CI:1.23-1.50,P＜0.001)for each one standard deviation(0.29)increase in baseline AIP.Compared with the participants in T1 group,the risk of new-onset ischemic stroke increased by 12％(HR=1.12,95％CI:1.04-1.20,P＜0.001)and 26％(HR=1.26,95％CI:1.18-1.36,P＜0.001)among those in T2 and T3 group,respectively.Further analysis showed that there was no significant difference in the risk of new-onset ischemic stroke among different tertiles of AIP after adjusting for above confounders in the second year of the follow-up.But in the fourth year of the follow-up,the risk of new-onset ischemic stroke in T3 group was significantly higher than that in T1 group(HR=1.24,95％CI:1.06-1.46,P=0.009).Conclusions Elevated AIP is an independent risk factor for new-onset ischemic stroke,and its pathogenic effects may manifest as early as within 2 to 4 years.
关键词
缺血性脑卒中/动脉粥样硬化/血浆致动脉粥样硬化指数/危险因素Key words
Ischemic stroke/Atherosclerosis/Atherogenic index of plasma/Risk factor引用本文复制引用
出版年
2024
NETL
NSTL
万方数据