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Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study

OBJECTIVE: Evidence regarding the relationship between serum triglyceride-to-high density lipoprotein cholesterol (TG/HDL-c) ratio and outcomes in acute ischemic stroke (AIS) patients is still mixed. Therefore, the present study was undertaken to explore the link between the TG/HDL-c ratio and unfav...

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Autores principales: Han, Yong, Huang, Zhiqiang, Zhou, Jinsong, Wang, Zhibin, Li, Qiming, Hu, Haofei, Liu, Dehong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287925/
https://www.ncbi.nlm.nih.gov/pubmed/35842590
http://dx.doi.org/10.1186/s12883-022-02791-2
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author Han, Yong
Huang, Zhiqiang
Zhou, Jinsong
Wang, Zhibin
Li, Qiming
Hu, Haofei
Liu, Dehong
author_facet Han, Yong
Huang, Zhiqiang
Zhou, Jinsong
Wang, Zhibin
Li, Qiming
Hu, Haofei
Liu, Dehong
author_sort Han, Yong
collection PubMed
description OBJECTIVE: Evidence regarding the relationship between serum triglyceride-to-high density lipoprotein cholesterol (TG/HDL-c) ratio and outcomes in acute ischemic stroke (AIS) patients is still mixed. Therefore, the present study was undertaken to explore the link between the TG/HDL-c ratio and unfavorable outcomes in patients with AIS. METHODS: This was a second analysis based on a cohort study. The study population was 1764 patients with AIS collected from January 2010 to December 2016 at a hospital in South Korea. We used a binary logistic regression model to assess the linear association between the TG/HDL-c ratio and unfavorable outcomes for AIS patients. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) was conducted to explore the nonlinear relationship between TG/HDL-c ratio and unfavorable outcomes for AIS patients. Additionally, we compute the inflection point using a recursive algorithm and then build a two-piece binary logistic regression model on both sides of the inflection point. A log-likelihood ratio test was used to determine the most appropriate model describing the association of TG/HDL-c ratio and unfavorable outcomes in patients with AIS. RESULTS: The incidence rate of unfavorable outcomes was 28.2%, and the median TG/HDL-c ratio was 2.130. After adjusting covariates, the results of the binary logistic regression model suggested that the relationship between the TG/HDL-c ratio and the risk of unfavorable outcomes for AIS patients was not statistically significant. However, there was a nonlinear relationship between them, and the inflection point of the TG/HDL-c ratio was 3.515. On the left side of the inflection point, each 1-unit increase in the TG/HDL-c ratio was associated with a 22.6% lower risk of unfavorable outcomes (OR = 0.774, 95%CI:0.656 to 0.914, p = 0.002). On the right side of the inflection point, the effect size (OR) was 1.195 (95%CI:1.004 to1.423, p = 0.003). CONCLUSION: There is a nonlinear relationship and threshold effect between the TG/HDL-c ratio and 3-month unfavorable outcomes in AIS patients. When the TG/HDL-c ratio is lower than 3.515, the TG/HDL-c ratio is significantly negatively related to the risk of unfavorable outcomes. When the TG/HDL-c ratio is greater than 3.515, the TG/HDL-c ratio was positively associated with the risk of unfavorable outcomes in AIS patients. This provides a reference for optimizing lipidemia intervention and promoting clinical communication in patients with AIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02791-2.
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spelling pubmed-92879252022-07-17 Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study Han, Yong Huang, Zhiqiang Zhou, Jinsong Wang, Zhibin Li, Qiming Hu, Haofei Liu, Dehong BMC Neurol Research OBJECTIVE: Evidence regarding the relationship between serum triglyceride-to-high density lipoprotein cholesterol (TG/HDL-c) ratio and outcomes in acute ischemic stroke (AIS) patients is still mixed. Therefore, the present study was undertaken to explore the link between the TG/HDL-c ratio and unfavorable outcomes in patients with AIS. METHODS: This was a second analysis based on a cohort study. The study population was 1764 patients with AIS collected from January 2010 to December 2016 at a hospital in South Korea. We used a binary logistic regression model to assess the linear association between the TG/HDL-c ratio and unfavorable outcomes for AIS patients. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) was conducted to explore the nonlinear relationship between TG/HDL-c ratio and unfavorable outcomes for AIS patients. Additionally, we compute the inflection point using a recursive algorithm and then build a two-piece binary logistic regression model on both sides of the inflection point. A log-likelihood ratio test was used to determine the most appropriate model describing the association of TG/HDL-c ratio and unfavorable outcomes in patients with AIS. RESULTS: The incidence rate of unfavorable outcomes was 28.2%, and the median TG/HDL-c ratio was 2.130. After adjusting covariates, the results of the binary logistic regression model suggested that the relationship between the TG/HDL-c ratio and the risk of unfavorable outcomes for AIS patients was not statistically significant. However, there was a nonlinear relationship between them, and the inflection point of the TG/HDL-c ratio was 3.515. On the left side of the inflection point, each 1-unit increase in the TG/HDL-c ratio was associated with a 22.6% lower risk of unfavorable outcomes (OR = 0.774, 95%CI:0.656 to 0.914, p = 0.002). On the right side of the inflection point, the effect size (OR) was 1.195 (95%CI:1.004 to1.423, p = 0.003). CONCLUSION: There is a nonlinear relationship and threshold effect between the TG/HDL-c ratio and 3-month unfavorable outcomes in AIS patients. When the TG/HDL-c ratio is lower than 3.515, the TG/HDL-c ratio is significantly negatively related to the risk of unfavorable outcomes. When the TG/HDL-c ratio is greater than 3.515, the TG/HDL-c ratio was positively associated with the risk of unfavorable outcomes in AIS patients. This provides a reference for optimizing lipidemia intervention and promoting clinical communication in patients with AIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02791-2. BioMed Central 2022-07-16 /pmc/articles/PMC9287925/ /pubmed/35842590 http://dx.doi.org/10.1186/s12883-022-02791-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Han, Yong
Huang, Zhiqiang
Zhou, Jinsong
Wang, Zhibin
Li, Qiming
Hu, Haofei
Liu, Dehong
Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title_full Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title_fullStr Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title_full_unstemmed Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title_short Association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
title_sort association between triglyceride-to-high density lipoprotein cholesterol ratio and three-month outcome in patients with acute ischemic stroke: a second analysis based on a prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287925/
https://www.ncbi.nlm.nih.gov/pubmed/35842590
http://dx.doi.org/10.1186/s12883-022-02791-2
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