上海预防医学2025，Vol.37Issue(6)：515-520,6.DOI:10.19428/j.cnki.sjpm.2025.24714
甘油三酯-葡萄糖指数和同型半胱氨酸与中老年2型糖尿病人群脑卒中发病风险的关联
Triglyceride-glucose index and homocysteine in association with the risk of stroke in middle-aged and elderly diabetic populations
摘要
Abstract
[Objective]To investigate the triglyceride-glucose(TyG)index and the level of serum homocysteine(Hcy)in association with the incidence of stroke in type 2 diabetes mellitus(T2DM)patients.[Methods]Based on the chronic disease risk factor surveillance cohort in Pudong New Area,Shanghai,excluding those with stroke in baseline survey,T2DM patients who joined the cohort from January 2016 to October 2020 were selected as the research subjects.During the follow-up period,a total of 318 new-onset ischemic stroke patients were selected as the case group,and a total of 318 individuals matched by gender without stroke were selected as the control group.The Cox proportional hazards regression model was used to adjust for confounding factors and explore the serum TyG index and the Hcy biochemical indicator in association with the risk of stroke.[Results]The Cox proportional hazards regression results showed that after adjusting for confounding factors,the risk of stroke in T2DM patients with 10 μmol·L-1<Hcy≤15 μmol·L-1 and Hcy>15 μmol·L-1 was 1.532 times(95%CI:1.017-2.309 times,P=0.041)and 1.738 times(95%CI:1.119-2.699 times,P=0.014)higher respectively,compared to T2DM patients with Hcy≤10 μmol·L-1.T2DM patients with TyG>9.074 had 1.396 times higher risk of stroke(95%CI:1.091-1.787,P=0.008)compared to those with TyG≤9.074.The study found that urea and α1-antitrypsin(α1-AT)were independent risk factors for the incidence of stroke in T2DM patients.For every unit increase in urea and α1-AT,the risk of stroke in T2DM patients increased by 233.6%(HR=3.336,95%CI:1.588-7.009,P=0.001)and 11.3%(HR=1.113,95%CI:1.028-1.205,P=0.008),respectively.Cumulative risk curves showed that Hcy>10 μmol·L-1 and TyG>9.074 accelerated the time to stroke occurrence in T2DM patients.[Conclusion]Elevated levels of Hcy>10 μmol·L-1 and a higher TyG index are risk factors for stroke in T2DM patients.Effective interventions for Hcy and TyG should be conducted for diabetic patients to reduce the incidence of stroke.关键词
2型糖尿病/脑卒中/同型半胱氨酸/甘油三酯-葡萄糖指数Key words
type 2 diabetes mellitus/stroke/homocysteine/triglyceride-glucose index分类
医药卫生引用本文复制引用
刘晓琳,高娇娇,刘杨,徐倩,周弋,阮晓楠,张金,李智韬,王小楠,柯居中,吴抗,邱桦,刘庆平,宋家慧..甘油三酯-葡萄糖指数和同型半胱氨酸与中老年2型糖尿病人群脑卒中发病风险的关联[J].上海预防医学,2025,37(6):515-520,6.基金项目
上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2022-02) （PWRq2022-02）
