METS-IR与中老年高血压患者脑卒中的相关性  

Correlation Between METS-IR and Stroke Occurrence in Middle-Aged and Elderly Hypertensive Patients

作　　者：孙继红[1] 刘恒道 汤毅[1] 李海禹[1] 张胜叶 桑海强[1] SUN Jihong;LIU Hengdao;TANG Yi;LI Haiyu;ZHANG Shengye;SANG Haiqiang(Department of Cardiology Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450000

出　　处：《河南医学研究》2024年第19期3474-3478,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190090)。

摘　　要：目的分析胰岛素抵抗代谢评分(METS-IR)与中老年高血压患者发生脑卒中的相关性。方法本研究筛选了2022年6月至2023年11月于郑州大学第一附属医院心血管内科住院的高血压患者849例,根据病史及头颅磁共振成像(MRI)磁共振血管成像(MRA)分为卒中组(482例)和对照组(367例)。应用logistic回归分析METS-IR水平与患病风险的相关性。结果单因素logistic回归分析卒中组吸烟史、体重指数(BMI)、收缩压(SBP)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(HCY)均高于对照组,差异有统计学意义(P<0.05)。在多因素logistic回归分析模型中,在校正相关混杂因素后,与处于METS-IR最低四分位数的受试者相比,处于METS-IR最高四分位数受试者患病风险增加93%(P=0.031)。受试者工作特征(ROC)曲线下面积为0.798,METS-IR最佳临界值为39.89。结论METS-IR升高与中老年高血压患者脑卒中发生相关,是其独立危险因素,具有一定的预测价值。随着METS-IR水平升高,脑卒中的患病风险增加。Objective To analyze the correlation between metabolic score for insulin resistance(METS-IR)and stroke in middle-aged and elderly hypertensive patients.Methods This study screened 849 hypertensive patients admitted to the Cardiovascular Department of the First Affiliated Hospital of Zhengzhou University from June 2022 to November 2023.Based on their medical history and head magnetic resonance imaging(MRI)and magnetic resonance angiography(MRA),they were divided into a stroke group(482 cases)and a control group(367 cases).Logistic regression analysis was applied to investigate the correlation between METS-IR levels and disease risk.Results Single factor logistic regression analysis showed that the smoking history,body mass index(BMI),systolic blood pressure(SBP),fasting blood glucose(FBG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and homocysteine(HCY)in the stroke group were higher than those in the control group,and the differences were statistically significant(P<0.05).In the multiple logistic regression analysis model,after adjusting for relevant confounding factors,subjects in the highest quartile of METS-IR had a 93%increased risk of disease compared to those in the lowest quartile of METS-IR(P=0.031).The area under the receiver operating characteristic(ROC)curve was 0.798,and the optimal critical value for METS-IR was 39.89.Conclusion Elevated METS-IR is associated with stroke in middle-aged and elderly hypertensive patients,and is an independent risk factor with certain predictive value.As METS-IR levels increase,the risk of stroke increases.

关 键 词：胰岛素抵抗代谢评分 高血压 脑卒中 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]