Semptomatik karotis darlığına bağlı iskemik inmenin trigliserid-glukoz indeksi ile ilişkisi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İskemik inme, önemli bir ölüm ve özürlülük nedenidir. Aterosklerotik karotis plaklarının yol açtığı semptomatik İCA stenozu, inmeden korunmada önemli bir hedeftir. HT, DM, sigara gibi; IR de önemli bir risk faktörü olup yeni nesil bir IR belirteci olan TyG indeksi ile ateroskleroz arasındaki ilişki çalışmalarda gösterilmiştir. Çalışmamızda semptomatik İCA darlığına bağlı ve diğer etyolojilere bağlı inmelerde TyG indeksiyle korelasyon olup olmadığını tespit etmeyi amaçladık. Gereç ve Yöntem: 2014-2022 arasında iskemik inme nedeniyle DSA yapılmış olan 360 hasta retrospektif incelenerek iki gruba ayrıldı. İlk gruba (n=202) iskemik inme etyolojisinin ?%50 semptomatik karotis stenozuna bağlandığı hastalar, ikinci gruba (n=158) etyolojide diğer tüm nedenler olanlar alındı. Hastalar laboratuvar parametreleri, özgeçmiş, alışkanlık, KAS yüzdesi, akut inme, TOAST sınıflaması açısından değerlendirildi. Bulgular: Yaş ve cinsiyet bakımından benzer olan gruplarda ortalama±SD değerleri, 1. grupta HDL 39,72±9,4, 2. grupta 42,37±10,84 (p=0,014); 1. grupta TC/HDL 5,06±1,53, 2. grupta 4,7±1,27 (p=0,019); 1. grupta TG 168,69±93,87, 2. grupta 139,34±79,69 (p=0,002); 1. grupta TyG indeksi 9,06±0,6, 2. grupta 8,87±0,62 (p=0,003) bulundu. DSA'da KAS ?%70 olanlar <%50 olanlarla kıyaslandığında median min-maks değerleri, 1. grupta LDL/HDL 3,2 (0,9-9,9), 2. grupta 3 (1,3-9,4) (p=0,131); 1. grupta TC/HDL 4,9 (2,5-12,9), 2. grupta 4,7 (2,3-12) (p=0,024); 1. grupta TG 155 (46-631), 2. grupta 139,8 ± 79,6 (p<0,001); 1. grupta TyG indeksi 9 (7,7-10,9), 2. grupta 8,8 (7,7-11,2) (p=0,002); 1. grupta HDL 39 (14-77), 2. grupta 40,9 (19-81,5) (p=0,038) bulundu. Semptomatik İCA stenozuna bağlı inme ile (1)TyG indeksi arasındaki ilişkinin tespiti için cut-off değeri 8,976'nın alınabileceğini [EAA 0,603 (95% GA 0,544-0,662); %56,9 duyarlılık, %43 özgüllük, p<0,001]; (2)TC/HDL ile arasındaki ilişkinin tespiti için cut- off değeri 4,866 [EAA 0,568 (95% GA 0,509-0,627); %54,5 duyarlılık, %45,6 özgüllük, p=0,026] tespit edildi. Sonuçlar: Semptomatik İCA stenozu üzerine TyG indeksinin önemli derecede anlamlı etkisi vardır, TyG indeksinin yönetimiyle erken dönem ateroskleroz progresyonunun önlenmesi için indeks takibi göz önüne alınmalıdır. Anahtar Kelimeler: karotis stenozu, trigliserit-glukoz indeksi, iskemik inme, dijital substraksiyon anjiyografi, ateroskleroz
Objective: Ischemic stroke is an important cause of death and disability. Symptomatic ICA stenosis caused by atherosclerotic carotid plaques is an important goal in stroke prevention. Just like HT, DM, smoking; IR is also an important risk factor and the relationship between the new IR predictor called "TyG index" and atherosclerosis has been shown in studies. In our study, we aimed to determine whether there is a correlation between the TyG index and strokes due to symptomatic ICA stenosis and due to other etiologies. Materials and Method: 360 patients who underwent DSA in our center due to ischemic stroke between 2014 and 2022 were analyzed retrospectively and divided into two groups. Patients with ?50% symptomatic carotid stenosis were included in the first group (n=202), and patients with all other etiologies were in the second group (n=158). The patients were evaluated in terms of laboratory parameters, medical and family history, tobacco usage, stenosis percentage, acute stroke and TOAST classification. Results: Groups were similar in terms of age and gender. HDL was found 39,72±9,4 in group 1 and 42,37±10,84 in group 2 (p=0,014); TC/HDL was found 5,06±1,53 in group 1 and 4,7±1,27 in group 2 (p=0,019); TG was found 168,69±93,87 in group 1 and 139,34±79,69 in group 2 (p=0,002). TyG index was found 9,06±0,6 in group 1 and 8,87±0,62 in group 2 (p=0,003). Comparing those with ?70% stenosis on DSA with <50% stenosis, median (min-max) values were LDL/HDL 3.2 (0.9-9.9) in group 1, 3 (1.3- 9.4 in group 2) ) (p=0.131); TC/HDL 4.9 (2.5-12.9) in group 1, 4.7 (2.3-12) in group 2 (p=0.024); TG 155 (46-631) in group 1, 139.8 ± 79.6 in group 2 (p<0.001); TyG index was 9 (7.7 - 10.9) in group 1, 8.8 (7.7 - 11.2) in group 2 (p=0.002); HDL was 39 (14 - 77) in group 1 and 40.9 (19 - 81.5) in group 2 (p=0.038). A cut-off value of 8.976 can be taken to determine the relationship between stroke due to symptomatic ICA stenosis and (1)TyG index [AUC 0.603 (95% CI 0.544-0.662); 56.9% sensitivity, 43% specificity, p<0.001]; (2) A cut-off value of 4.866 can be taken to determine the relationship between TC/HDL [EAA 0.568 (95% CI 0.509-0.627); We found a sensitivity of 54.5%, specificity of 45.6%, p=0.026]. Conclusions: The TyG index has a significant effect on symptomatic ICA stenosis, and index follow-up should be considered to prevent early atherosclerosis progression with the management of the TyG index. Keywords: carotid stenosis, triglyceride-glucose index, ischemic stroke, digital substraction angiography, atherosclerosis
Objective: Ischemic stroke is an important cause of death and disability. Symptomatic ICA stenosis caused by atherosclerotic carotid plaques is an important goal in stroke prevention. Just like HT, DM, smoking; IR is also an important risk factor and the relationship between the new IR predictor called "TyG index" and atherosclerosis has been shown in studies. In our study, we aimed to determine whether there is a correlation between the TyG index and strokes due to symptomatic ICA stenosis and due to other etiologies. Materials and Method: 360 patients who underwent DSA in our center due to ischemic stroke between 2014 and 2022 were analyzed retrospectively and divided into two groups. Patients with ?50% symptomatic carotid stenosis were included in the first group (n=202), and patients with all other etiologies were in the second group (n=158). The patients were evaluated in terms of laboratory parameters, medical and family history, tobacco usage, stenosis percentage, acute stroke and TOAST classification. Results: Groups were similar in terms of age and gender. HDL was found 39,72±9,4 in group 1 and 42,37±10,84 in group 2 (p=0,014); TC/HDL was found 5,06±1,53 in group 1 and 4,7±1,27 in group 2 (p=0,019); TG was found 168,69±93,87 in group 1 and 139,34±79,69 in group 2 (p=0,002). TyG index was found 9,06±0,6 in group 1 and 8,87±0,62 in group 2 (p=0,003). Comparing those with ?70% stenosis on DSA with <50% stenosis, median (min-max) values were LDL/HDL 3.2 (0.9-9.9) in group 1, 3 (1.3- 9.4 in group 2) ) (p=0.131); TC/HDL 4.9 (2.5-12.9) in group 1, 4.7 (2.3-12) in group 2 (p=0.024); TG 155 (46-631) in group 1, 139.8 ± 79.6 in group 2 (p<0.001); TyG index was 9 (7.7 - 10.9) in group 1, 8.8 (7.7 - 11.2) in group 2 (p=0.002); HDL was 39 (14 - 77) in group 1 and 40.9 (19 - 81.5) in group 2 (p=0.038). A cut-off value of 8.976 can be taken to determine the relationship between stroke due to symptomatic ICA stenosis and (1)TyG index [AUC 0.603 (95% CI 0.544-0.662); 56.9% sensitivity, 43% specificity, p<0.001]; (2) A cut-off value of 4.866 can be taken to determine the relationship between TC/HDL [EAA 0.568 (95% CI 0.509-0.627); We found a sensitivity of 54.5%, specificity of 45.6%, p=0.026]. Conclusions: The TyG index has a significant effect on symptomatic ICA stenosis, and index follow-up should be considered to prevent early atherosclerosis progression with the management of the TyG index. Keywords: carotid stenosis, triglyceride-glucose index, ischemic stroke, digital substraction angiography, atherosclerosis
Açıklama
Anahtar Kelimeler
Nöroloji, Neurology
