| ObjectiveThere is no definite conclusion about the correlation between the prognosis of ischemic stroke（IS）and triglyceride（TG）levels,especially in China,where there is sufficient research evidence and a large enough sample size.Less research.Therefore,focusing on IS patients,using large-sample clinical retrospective research methods to explore the relationship between their TG levels on admission and the long-term mortality risk.Subjects and methods1.Subjects:The Yixing Hospital affiliated to Jiangsu University was used as the research site.The survey subjects were 2207 patients who were admitted to the hospital and discharged from the hospital with the first diagnosis of IS from April 2009 to December 2017.A total of 1964 cases were finally included in the statistics.2.Methods:A uniformly designed questionnaire was used to record in detail the baseline data of patients upon admission,including general information,past history,family history,physical examination,laboratory examinations and other related data.A intensive follow-up was conducted from December 2018 to April 2019 to observe the patient’s outcome,including survival,death,and loss to follow-up.If death,the cause of death was determined.3.Statistical analysis:Epidata 3.1 is used to establish a database,and all questionnaires have been checked by two persons with double records.Perform statistical analysis using software SPSS25.0,compare differences in non-normally distributed continuous variables using the Mann-Whitney U test,and compare differences in categorical variable distributions using the~2 test,and the TG at admission was fitted according to the restricted cubic spline regression analysis.The curve relationship with IS death and the appropriate TG cut-off point were determined.Cox regression was used to analyze the Hazard ratio（HR）and 95%confidence interval（CI）of TG level and IS death at admission.Results1、A total of 1964 IS patients were included in this study,excluding 145 patients who were lost to follow-up and 98 patients with missing information,.They were followed up for a total of8060.32 person-years.During the follow-up period,101 people（5.1%）died of IS.Among them,1197 cases（60.9%）were male and 767 cases（39.1%）were female.The median age was 68 years（60.3,75.0）,and the median survival time was 3.45 years（1.53,6.85）.There were 482 smoking patients（24.5）,310 drinking patients（15.8%）,1366 patients（69.6%）with a history of hypertension,and 526 patients（26.8%）with a history of diabetes.There were 931 cases in the TG≤1.3mmol/L group,including 614（66%）males and 317（34.0%）females.The median age was 69.0 years（62.0,77.0）,and the median survival time was 3.25 years（1.50,6.68）.There were 620 patients（66.6%）with a history of hypertension,243 patients（26.1%）with a history of diabetes,870 patients（93.4%）in the survival group,and 61 patients（6.6%）in the death group.2、According to the results of restricted cubic spline regression analysis,the population was divided into groups with 1.3mmol/L as the cutoff point.There were 931 cases in the TG≤1.3mmol/L group,including 614（66%）males and 317（34.0%）females.The median age was 69.0years（62.0,77.0）,and the median survival time was 3.25 years（1.50,6.68）.There were 229smoking patients（24.6%）,148 drinking patients（15.9%）,620 patients（66.6%）with a history of hypertension,and 243 patients（26.1%）with a history of diabetes.61 cases（6.6%）died of IS.3、There were 1033 cases in the TG>1.3mmol/L group,including 583 males（56.4%）and 450females（43.6%）.The median age was 67.0 years（59.0,73.0）,and the median survival time was3.66 years（1.77,6.97）.There were 253 smoking patients（24.5%）,162 drinking patients（15.7%）,746 patients（72.2%）with a history of hypertension,283 patients（27.4%）with a history of diabetes,and 40 deaths（3.9%）due to IS.4、Through multivariate Cox regression analysis,it is clear that the risk of death in patients with TG>1.3 mmol/L is 45.6%lower than that in the TG≤1.3mmol/L group（HR=0.546 95%CI0.366～0.814 P=0.003）,and the test result is P<0.05,that is,there is a significant difference.After adjusting for some risk factors,the death risk of patients with TG>1.3 mmol/L was 36.3%lower than that of the TG≤1.3mmol/L group（HR=0.637 95%CI 0.420～0.966 P=0.034）,the test result was P<0.05,That is,there is a significant difference.5、The results of further subgroup analysis showed that for patients with large atherosclerotic stroke,TG≤1.3mmol/L increased the risk of IS death.After adjusting for confounding factors,the association was still statistically significant.HRs（95%CI）before and after adjustment were respectively It is 1.922（1.056-3.499）and 1.900（1.020-3.537）.In people 65 years and older,non-drinkers,and non-diabetic people,before and after adjusting for confounding factors,compared with those with TG>1.3mmol/L,those with TG≤1.3mmol/L had an increased risk of IS death.After adjustment for multiple factors HRs（95%CI）were 1.650（1.062-2.565）,1.549（1.009-2.379）,and 1.750（1.083-2.828）.In men,non-smokers,hypertensive and non-hypertensive populations,before adjustment for multiple factors,TG≤1.3mmol/L is associated with an increased risk of IS death,but after adjustment for multiple factors,the strength of the association weakens and is no longer statistically significant（P>0.05）.ConclusionsLow TG levels at admission of IS patients can increase the long-term mortality risk,Regulating TG levels is meaningful for the treatment and prognosis of IS. |
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