Glycated albumin levels are associated with adverse stroke outcomes in patients with acute ischemic stroke in China

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-09-12 DOI:10.1111/1753-0407.13600

Jiawen Mao, Meng Wang, Chunjuan Wang, Hongqiu Gu, Xia Meng, Yong Jiang, Xin Yang, Jing Zhang, Yunyun Xiong, Xingquan Zhao, Liping Liu, Yilong Wang, Yongjun Wang, Zixiao Li, Bihong Zhu

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引用次数: 0

Abstract

Background and Aim

Glycated albumin (GA) is a biomarker monitoring glycemia 2–4 weeks before stroke onset. This study was designed to explore the association between GA levels with poststroke outcomes in patients with acute ischemic stroke or transient ischemic attack (TIA).

Method

Participants with ischemic stroke or TIA who had a baseline GA measurement were included in the Third China National Stroke Registry study. The effect of GA on stroke recurrence, poor functional outcomes, and combined vascular events was examined during the 1-year follow-up period. Multivariate Cox and logistic regression models were performed to evaluate the association. Discrimination tests were used to examine the incremental predictive value of GA when incorporating it into the conventional model.

Results

A total of 3861 participants were enrolled. At the 3-month follow-up, the elevated GA level was associated with an increased risk of poor functional outcomes (adjusted odds ratio [OR], 1.45; 95% confidence interval [CI], 1.01–2.09). A similar increase was observed for stroke recurrence (adjusted hazard ratio [HR], 1.56; 95% CI, 1.09–2.24), poor functional outcomes (adjusted OR, 1.62; 95% CI, 1.07–2.45), and combined vascular events (adjusted HR, 1.55; 95% CI, 1.09–2.20) at the 1-year follow-up. In nondiabetic patients, the association between GA and poor functional outcomes was more pronounced (adjusted OR, 1.62; 95% CI, 1.05–2.50). Adding GA into the conventional model resulted in slight improvements in predicting poor functional outcomes (net reclassification improvement [NRI]: 12.30% at 1 year).

Conclusion

This study demonstrated that elevated GA levels in serum were associated with stroke adverse outcomes, including stroke recurrence, poor functional outcomes, and combined vascular events, in patients with ischemic stroke or TIA.

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糖化白蛋白水平与中国急性缺血性脑卒中患者的不良卒中预后有关

背景和目的糖化白蛋白（GA）是中风发病前 2-4 周监测血糖的生物标志物。本研究旨在探讨 GA 水平与急性缺血性卒中或短暂性脑缺血发作（TIA）患者卒中后预后的关系。方法第三次中国全国脑卒中登记研究纳入了基线 GA 测量的缺血性脑卒中或 TIA 患者。在 1 年的随访期间，研究人员考察了 GA 对脑卒中复发、不良功能预后和合并血管事件的影响。采用多变量 Cox 模型和逻辑回归模型来评估相关性。在将 GA 纳入传统模型时，使用了判别测试来检验 GA 的增量预测价值。结果共有 3861 人参加了研究。在 3 个月的随访中，GA 水平的升高与不良功能预后风险的增加有关（调整后的比值比 [OR]，1.45；95% 置信区间 [CI]，1.01-2.09）。中风复发（调整后危险比 [HR]，1.56；95% 置信区间 [CI]，1.09-2.24）、不良功能预后（调整后 OR，1.62；95% 置信区间 [CI]，1.07-2.45）和综合血管事件（调整后 HR，1.55；95% 置信区间 [CI]，1.09-2.20）在 1 年随访中也观察到类似的增加。在非糖尿病患者中，GA 与不良功能预后之间的关系更为明显（调整后 OR，1.62；95% CI，1.05-2.50）。将 GA 加入传统模型后，不良功能预后的预测结果略有改善（1 年后的净重新分类改善率 [NRI]：12.30%）。结论本研究表明，血清中 GA 水平升高与缺血性卒中或 TIA 患者的卒中不良预后有关，包括卒中复发、不良功能预后和合并血管事件。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.