甘油三酯-葡萄糖指数与脑小血管病及其影像学标志物关系研究  

Study on the relationship between triglyceride glucose index and cerebral small vessel disease and its different imaging markers

作　　者：尹园园 罗伟刚 刘万虎 步玮[2] 徐玉珠 曹晓芸 任慧玲[1] YIN Yuan‑yuan;LUO Wei‑gang;LIU Wan‑hu;BU Wei;XU Yu‑zhu;CAO Xiao‑yun;REN Hui‑ling(Department of Neurology,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China;Department of Neurosurgery,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北医科大学第三医院神经内科,石家庄050051 [2]河北医科大学第三医院神经外科,石家庄050051

出　　处：《中国现代神经疾病杂志》2023年第11期993-1000,共8页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：河北省重点科技研究计划项目(项目编号:20170651);河北省医学科学研究课题计划项目(项目编号:20240198)。

摘　　要：目的探讨甘油三酯-葡萄糖(TyG)指数与脑小血管病总负荷和脑小血管病影像学标志物的关系。方法纳入河北医科大学第三医院2020年1月至2022年5月确诊的202例脑小血管病患者,收集临床资料并计算TyG指数;MRI评估腔隙、脑微出血、脑白质高信号和扩大的血管周围间隙,计算脑小血管病总负荷评分。结果(1)TyG指数与脑小血管病总负荷:Logistic回归分析显示,男性(OR=2.245,95%CI:1.017~4.957;P=0.045)、年龄增大(OR=1.084,95%CI:1.046~1.124;P=0.000)、高血压(OR=2.457,95%CI:1.189~5.078;P=0.015)和TyG指数升高(OR=2.657,95%CI:1.353~5.216;P=0.005)是中重度脑小血管病总负荷的危险因素。(2)TyG指数与脑小血管病影像学标志物:Logistic回归分析显示,TyG指数升高是中重度脑白质高信号(OR=2.313,95%CI:1.095~4.885;P=0.028)、脑微出血(OR=1.690,95%CI:1.011~2.824;P=0.045)、腔隙(OR=2.087,95%CI:1.235~3.525;P=0.006)和中重度基底节区扩大的血管周围间隙(OR=2.005,95%CI:1.190~3.378;P=0.009)的危险因素。结论TyG指数与脑小血管病总负荷及其各项影像学标志物之间均存在关联性,可作为评估脑小血管病及其严重程度的生物学标志物。Objective To investigate the relationship between triglyceride glucose(TyG)index and the total load of cerebral small vessel disease(CSVD)and its different imaging markers.Methods A total of 202 patients with CSVD admitted to The Third Hospital of Hebei Medical University from January 2020 to May 2022 were selected.The clinical data of all patients were collected and TyG index was calculated.The lacunes,cerebral microbleeds(CMBs),white matter hyperintensity(WMH)and enlarged perivascular space(EPVS)were evaluated by MRI,and total load of CSVD score was calculated.Results 1)TyG index and total load of CSVD score:Logistic regression analysis showed the male(OR=2.245,95%CI:1.017-4.957;P=0.045),increase of age(OR=1.084,95%CI:1.046-1.124;P=0.000),hypertension(OR=2.457,95%CI:1.189-5.078;P=0.015)and increase of TyG index(OR=2.657,95%CI:1.353-5.216;P=0.005)were risk factors for moderate and severe total load of CSVD.2)TyG index and imaging markers of CSVD:Logistic regression analysis showed the increase of TyG index was the risk factor of moderate and severe WMH(OR=2.313,95%CI:1.095-4.885;P=0.028),CMBs(OR=1.690,95%CI:1.011-2.824;P=0.045),lacunes(OR=2.087,95%CI:1.235-3.525;P=0.006),moderate and severe EPVS in basal ganglia(OR=2.005,95%CI:1.190-3.378;P=0.009).Conclusions TyG index is associated with the total load and various imaging markers of CSVD,which can be used as a valuable biomarker to evaluate CSVD and its severity.

关 键 词：大脑小血管疾病 甘油三酯类 葡萄糖 胰岛素抵抗 危险因素 LOGISTIC模型 

分 类 号：R743[医药卫生—神经病学与精神病学]