血浆动脉粥样硬化指数和高敏c反应蛋白与脑卒中的联合关联：一项大规模前瞻性队列研究。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-09-10 DOI:10.1016/j.jstrokecerebrovasdis.2025.108450

Yu-Hua Liu MD , Qiong-Hui Lao MD , Rong-Rui Huo MD , Cui Ma MD

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引用次数: 0

摘要

背景：虽然血浆动脉粥样硬化指数（AIP）和高敏c反应蛋白（hs-CRP）都被认为是卒中的危险标志物，但它们的联合作用尚未完全了解。为了解决这一差距，我们引入了炎症性动脉粥样硬化指数（IAI），这是一种结合AIP和hs-CRP的复合测量方法，并研究了其预测卒中风险的潜力。IAI计算公式为：IAI = AIP × hs-CRP / 10。Cox比例风险模型用于估计与IAI相关的卒中风险。采用VanderWeele方法进行中介分析，评估收缩压和舒张压的中介作用。结果：研究纳入9687名参与者，平均基线年龄58.66岁（SD = 9.23），其中4542名（46.9%）为男性。在7年的随访期间，记录了662例卒中（6.8%）。在对所有协变量进行调整后，炎症性动脉粥样硬化指数（IAI）的每一个标准差（SD）增加与卒中风险增加11.0%相关（HR = 1.11,95% CI: 1.03-1.19）。IAI与卒中风险呈非线性倒u型关系（P = 0.015）。中介分析显示收缩压和舒张压介导了19.64%和25.79%的iai -卒中关联。Hs-CRP和AIP也协同作用增加卒中风险（协同指数 = 1.35,95% CI: 1.03-1.76）。结论：IAI与卒中风险增加有关，血压起中介作用。这突出了IAI作为卒中风险生物标志物的潜力，对高IAI患者进行早期干预可能会降低卒中风险。

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Joint associations of atherogenic index of plasma and high-sensitivity C-reactive protein on stroke: a large-scale prospective cohort study

Backgroud

Although both the atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) are recognized as risk markers for stroke, their combined effect has yet to be fully understood. To address this gap, we introduced the inflammatory atherogenic index (IAI), a composite measure incorporating AIP and hs-CRP, and investigated its potential in predicting stroke ris

Methods

We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). IAI was calculated using the formula: IAI = AIP × hs-CRP / 10. Cox proportional hazard models were used to estimate stroke risk associated with IAI. Mediation analysis using VanderWeele’s method evaluated the mediating role of systolic and diastolic blood pressures.

Results

The study included 9,687 participants with a mean baseline age of 58.66 years (SD = 9.23), of whom 4,542 (46.9%) were male. Over the 7-year follow-up period, 662 incident stroke cases (6.8%) were recorded. After adjusting for all covariates, each standard deviation (SD) increase in the inflammatory atherogenic index (IAI) was linked to an 11.0% higher stroke risk (HR = 1.11, 95% CI: 1.03–1.19). A nonlinear, inverted U-shaped relationship between IAI and stroke risk was observed (P = 0.015). Mediation analysis showed that systolic and diastolic blood pressures mediated 19.64% and 25.79% of the IAI-stroke association. Hs-CRP and AIP also interacted synergistically to increase stroke risk (synergy index = 1.35, 95% CI: 1.03–1.76).

Conclusions

IAI is associated with increased stroke risk, with mediation by blood pressure. This highlights the potential of IAI as a biomarker for stroke risk, with early intervention in patients with high IAI potentially reducing stroke risk.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.