非糖尿病患者甘油三酯葡萄糖指数和高敏C反应蛋白联合效应与脑扩大的血管周围间隙的相关性分析  

Correlation Analysis of the Combined Effect of Triglyceride Glucose Index and High-Sensitivity C-Reactive Protein with Enlarged Perivascular Spaces in the Brain of Non-Diabetic Patients

作　　者：蔡江萍[1] 黄小金 董汉升[1,2,3] 刘君毅 林洁 魏晓兰 CAI Jiangping;HUANG Xiaojin;DONG Hansheng;LIU Junyi;LIN Jie;WEI Xiaolan(Department of Neurology,The First Hospital of Quanzhou Affiliated to Fujian Medical University,Quanzhou 362000,China;The Third Clinical Medical College of Fujian Medical University,Fuzhou 350122,China;The Graduate School of Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]福建医科大学附属泉州第一医院神经内科,泉州362000 [2]福建医科大学第三临床医学院,福州350122 [3]福建医科大学研究生院,福州350122

出　　处：《福建医科大学学报》2023年第5期347-354,共8页Journal of Fujian Medical University

基　　金：福建省自然科学基金项目(2020J011284,2021J011407);福建省泉州市科学技术项目(2019C030R,2021N069S)。

摘　　要：目的探讨非糖尿病患者中甘油三酯葡萄糖(TyG)指数和高敏C反应蛋白(hs-CRP)联合效应与脑部扩大的血管周围间隙(EPVS)的相关性。方法收集2017年7月—2022年12月858例非糖尿病患者的临床资料。以TyG指数与hs-CRP中位数为界,分为低/低、低/高、高/低和高/高组。分析不同分组中EPVS负担和分布。结果多变量logistic回归模型显示,与低/低组比较,高/高组(OR:2.64,95%CI:1.63~4.26,P<0.001)、低/高组(OR:1.82,95%CI:1.11~2.99,P=0.017)的中重度EPVS患病风险增加,差别有统计学意义,而高/低组患病风险的差别无统计学意义(OR:1.02,95%CI:0.61~1.70,P=0.946)。对不同部位的EPVS分析发现,与低/低组比较,高/高组的中重度CSO-EPVS患病风险增加,差别有统计学意义(OR:1.76,95%CI:1.10~2.82,P=0.019),低/高组的中重度BG-EPVS患病风险增加,差别有统计学意义(OR:1.80,95%CI:1.04~3.11,P=0.036)。交互作用分析发现,TyG指数/hs-CRP联合效应、性别对EPVS的影响存在相乘交互作用(OR:8.84,95%CI:3.38~23.11,P<0.001,P-交互=0.014)。结论TyG指数与hs-CRP联合效应可增加脑中重度EPVS的患病风险。Objective To investigate the combined effects of triglyceride-glucose(TyG)index and high sensitivity C-reactive protein(hs-CRP)with enlarged perivascular spaces(EPVS)in the brain of non-diabetic patients.Methods Data were collected from 858 non-diabetic patients who visited the hospital between July 2017 and December 2022.According to the median value of TyG index and hs-CRP,they were divided into low/low,low/high,high/low,high/high groups,and the burden and distribution of EPVS in different groups were analyzed.Results Multivariate logistic regression model showed that compared with low/low group,high/high group(OR:2.64,95%CI:1.63-4.26;P<0.001)and low/high groups(OR:1.82,95%CI:1.11-2.99;P=0.017)were significantly increased in the risk of moderate to severe EPVS,while there was no significant difference in the prevalence of high/low groups(OR:1.02,95%CI:0.61-1.70;P=0.946).Analysis of EPVS on different regions showed that compared with low/low group,there were significant increased risk of moderate to severe centrum semiovale-EPVS in the high/high group(OR:1.76,95%CI:1.10-2.82;P=0.019)and basal ganglia-EPVS in the low/high group(OR:1.80,95%CI:1.04-3.11;P=0.036).Interaction analysis showed that the combined effect of TyG index and hs-CRP on EPVS interacted with sex(OR:8.84,95%CI:3.38-23.11;P<0.001,P-interaction=0.014).Conclusion The combined effects of TyG index and hs-CRP are associated with an increased risk of EPVS in the brain.

关 键 词：甘油三酯葡萄糖指数 非糖尿病患者 胰岛素抵抗 高敏C反应蛋白 血管周围间隙 

分 类 号：R743[医药卫生—神经病学与精神病学]