河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (12): 1387-1393.doi: 10.3969/j.issn.1007-3205.2024.12.005

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残余胆固醇水平与急性缺血性卒中患者体重指数的相关研究

  

  1. 1.西北大学附属第一医院，陕西省西安市第一医院神经内科，陕西 西安 710002；2.西安交通大学
    医学部公共卫生学院流行病与卫生统计学系，陕西 西安 710061

  • 出版日期:2024-12-25 发布日期:2025-01-03
  • 作者简介:刘仲仲（1984-），男，陕西渭南人，陕西省西安市第一医院助理研究员，医学博士研究生，从事脑血管疾病诊治研究。

Association between remnant cholesterol level and body mass index in patients with acute ischemic stroke

  1. 1.Department of Neurology, the First Affiliated Hospital of Northwest University, Xi′an No.1 Hospital, Shanxi Province, Xi′an, 710002 China; 2.Department of Epidemiology and Biostatistics, School of Public Health, Xi′an Jiaotong University Health Science Center, Shanxi Province, Xi′an 710061, China

  • Online:2024-12-25 Published:2025-01-03
  • Supported by:
    陕西省科技计划项目(2023-YBSF-041,2022SF-381,2022SF-507和2023-YBSF-052)；陕西省中医药管理局项目（2022-SLRH-LJ-013）；西安市科技计划项目(22YXYJ0061和22YXYJ0074)；西安市卫生健康委员会科研项目(2021yb33和2022qn11)

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摘要： 目的 探讨残余胆固醇（remnant cholesterol,RC）水平与急性缺血性卒中（acute ischemic stroke,AIS）患者体重指数（body mass index,BMI）的相关性。
方法 基于西安卒中登记研究数据库平台，回顾性分析西安市4所三级甲等医院2017年1—12月住院接受治疗AIS患者的临床基线资料、实验室检测结果。根据BMI将AIS患者分为体重偏低组（BMI＜18.5），体重正常组（18.5~23.9）、超重组（24.0~27.9 ）及肥胖组（≥28.0），分析不同BMI组患者临床特征的差异；通过多因素回归分析探讨AIS患者不同BMI与RC水平的关系，进一步按照年龄和性别分层探讨。
结果 最终纳入AIS患者2 509例，平均年龄（64.3±12.4）岁，其中男性1 575例（62.8%），女性934例（37.2%）。校正相关混杂因素后，多因素回归分析显示，肥胖组AIS患者的RC水平较正常体重组升高0.13 mmol/L（β=0.13，95%CI:0.02~0.23，P=0.015），而且随着BMI的升高RC水平升高的趋势具有显著性统计学意义（P=0.033）。按照年龄分层分析显示，年龄45~65岁的中老年肥胖AIS患者RC水平较正常体重患者升高0.23 mmol/L（β=0.23，95%CI:0.06~0.40，P=0.009），年龄≥65岁的老年体重偏低的AIS患者RC水平较正常体重患者降低0.14 mmol/L（β=-0.14，95%CI:-0.26~-0.03，P=0.017）。按照性别分层分析显示，仅在男性肥胖AIS患者中RC水平较正常体重升高0.16 mmol/L（β=0.16，95%CI:0.02~0.31，P=0.028），女性患者中两者无显著相关。
结论 RC水平在中老年肥胖的男性AIS患者中明显升高，可能与该类患者预后相关，临床医师应重点关注。


关键词: ischemic stroke, serum lipid, remnant cholesterol

Abstract: Objective To investigate the association between remnant cholesterol (RC) levels and body mass index (BMI) in patients with acute ischemic stroke (AIS). 
Methods Based on the Stroke Registry Study database platform, clinical baseline data and laboratory test results of AIS patients admitted to four grade-A tertiary hospitals in Xi′an City from January to December 2017 were retrospectively analyzed. Patients with AIS were divided into four groups according to BMI: low weight group (BMI <18.5), normal body mass group (BMI: 18.5-23.9), overweight group (BMI: 24.0-27.9) and obese group (BMI≥28.0), and compared differences in clinical characteristics in different BMI groups. Multivariate regression analysis was used to investigate the association between different BMI and RC levels in patients with AIS, which was further explored by stratifying according to age and gender. 
Results A total of 2 059 patients with AIS were finally included, with a mean age of (64.3±12.4) years, including 1 575 (62.8%) males and 934 (37.2%) females. After adjusting for relevant confounders, multivariate regression analysis showed that RC level was 0.13 mmol/L higher in AIS patients in obese group compared with normal weight group (β=0.13, 95%CI:0.02-0.23, P=0.015), and the trend of RC level increasing with the increase of BMI was statistically significant (P=0.033). Stratified analysis according to age revealed that the RC level was 0.23 mmol/L higher in obese AIS patients aged 45-65 years compared with normal weight patients (β=0.23, 95%CI: 0.06-0.40, P=0.009),and elderly AIS patients aged ≥65 years with low weight had a 0.14 mmol/L lower RC level than those with normal body weight (β=-0.14, 95%CI: -0.26--0.03, P=0.017).Stratified analysis by gender revealed that RC levels were significantly higher in obese AIS patients compared to normal body weight only in men (β=0.16, 95%CI: 0.02-0.31, P=0.028), but there was no significant correlation between RC and normal weight in women. 
Conclusion The level of RC is significantly increased in middle-aged and elderly obese male patients with AIS，which may be related to the prognosis of these patients, and warrant the attention of clinicians. 


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