ApoB/ApoA1比值、甘油三酯-葡萄糖指数与老年创伤性脑损伤严重程度和预后的关系

doi:10.3969/j.issn.1003-9198.2024.10.018

实用老年医学 ›› 2024, Vol. 38 ›› Issue (10): 1049-1053.doi: 10.3969/j.issn.1003-9198.2024.10.018

ApoB/ApoA1比值、甘油三酯-葡萄糖指数与老年创伤性脑损伤严重程度和预后的关系

李光耀, 叶碧华, 李小靓, 汤秦, 刘翠华

621000 四川省绵阳市,电子科技大学医学院附属绵阳医院(绵阳市中心医院)急诊医学科(李光耀,刘翠华);
621000 四川省绵阳市,四川绵阳四〇四医院健康管理中心(叶碧华);
621000 四川省绵阳市,绵阳市游仙区中医医院外科(李小靓);
621000 四川省绵阳市,绵阳顾连康复医院康复医学科(汤秦)

收稿日期:2023-11-15 出版日期:2024-10-20 发布日期:2024-10-22
通讯作者: 刘翠华,Email:1803298604@qq.com

Relationship of ApoB/ApoA1 ratio and triglyceride glucose index with severity and prognosis of traumatic brain injury in the elderly

LI Guangyao, YE Bihua, LI Xiaoliang, TANG Qin, LIU Cuihua

Department of Emergency Medicine, Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology (Mianyang Central Hospital), Mianyang 621000, China (LI Guangyao, LIU Cuihua);
Health Management Center, Sichuan Mianyang 404 Hospital, Mianyang 621000, China (YE Bihua);
Department of Surgery, Youxian District Hospital of Traditional Chinese Medicine, Mianyang 621000, China (LI Xiaoliang);
Department of Rehabilitation Medicine, Mianyang Gulian Rehabilitation Hospital, Mianyang 621000, China (TANG Qin)

Received:2023-11-15 Online:2024-10-20 Published:2024-10-22
Contact: LIU Cuihua, Email: 1803298604@qq.com

摘要/Abstract

摘要： 目的探讨载脂蛋白B(ApoB)/载脂蛋白A1(ApoA1)比值、甘油三酯-葡萄糖(TyG)指数与创伤性脑损伤(TBI)严重程度和预后的关系。方法选择2018年1月至2023年1月绵阳市中心医院收治的112例TBI病人(TBI组)和79例健康志愿者(对照组)。根据入院时格拉斯哥昏迷评分量表 (GCS)评分将TBI病人分为中度组(64例)和重度组(48例),出院6个月后采用格拉斯哥预后量表(GOS)评估神经预后,并据此将TBI病人分为预后不良组(23例)和预后良好组(89例)。收集临床资料,计算ApoB/ApoA1比值和TyG指数,采用Pearson相关系数描述ApoB/ApoA1比值和TyG指数与胰岛素抵抗(HOMA-IR)、GCS评分的相关性,采用多因素Logistic回归分析影响TBI病人预后的因素, 采用ROC曲线分析ApoB/ApoA1比值和TyG指数预测TBI病人预后的价值。结果 TBI组ApoB/ApoA1比值、TyG指数、HOMA-IR显著高于对照组(P＜0.05),且重度组高于中度组(P＜0.05)。TBI病人ApoB/ApoA1比值、TyG指数与GCS评分呈负相关(P＜0.05),与HOMA-IR呈正相关(P＜0.05)。脑室出血、高ApoB/ApoA1比值、高TyG指数、高HOMA-IR是TBI病人预后不良的危险因素(P＜0.05)。ApoB/ApoA1比值、TyG指数预测TBI病人预后的AUC分别为0.744、0.755,与HOMA-IR(0.794)接近(P＞0.05),联合ApoB/ApoA1比值、TyG指数、HOMA-IR预测TBI病人预后的AUC为0.888,大于各指标单独预测价值(P＜0.05)。结论 TBI病人ApoB/ApoA1比值、TyG指数增高与神经损伤加重和预后不良有关,检测ApoB/ApoA1比值、TyG指数有助于评估TBI病人预后不良风险。

关键词: 创伤性脑损伤, 胰岛素抵抗, 甘油三酯-葡萄糖指数, 载脂蛋白B, 载脂蛋白A1, 预后

Abstract: Objective To investigate the relationship of apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) ratio, triglyceride-glucose (TyG) index with the severity and prognosis of traumatic brain injury (TBI) in the elderly. Methods A retrospective study was conducted. A total of 112 patients with TBI (TBI group) and 79 healthy volunteers (control group) in Mianyang Central Hospital from January 2018 to January 2023 were selected. The patients with TBI were divided into moderate group (64 cases) and severe group (48 cases) according to the score of Glasgow Outcome Scale (GCS) at admission. The neurological prognosis was assessed by Glasgow Prognosis Scale (GOS) 6 months after discharge. According to GOS score, the patients with TBI were divided into poor prognosis group (23 cases) and good prognosis group (89 cases). The clinical data were collected, and ApoB/ApoA1 ratio and TyG index were calculated. Pearson correlation analysis was used to analyze the correlation of ApoB/ApoA1 ratio and TyG index with insulin resistance (HOMA-IR) and GCS score, and multivariate Logistic regression analysis was conducted to analyze the factors affecting the prognosis of TBI. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of ApoB/ApoA1 ratio and TyG index in predicting prognosis of TBI. Results ApoB/ApoA1 ratio, TyG index and HOMA-IR in TBI group were significantly higher than those in control group (P < 0.05), and were significantly higher in severe group than those in moderate group (P < 0.05). The ApoB/ApoA1 ratio and TyG index were negatively correlated with GCS score (P < 0.05), and positively correlated with HOMA-IR in the patients with TBI (P < 0.05). Ventricular hemorrhage, high ApoB/ApoA1 ratio, high TyG index and high HOMA-IR were risk factors for poor prognosis in TBI patients (P < 0.05). The area under the curve of ApoB/ApoA1 ratio and TyG index in predicting the prognosis of TBI was 0.744 and 0.755, which was close to HOMA-IR (0.794, P>0.05); The area under the curve of combination of ApoB/ApoA1 ratio, TyG index and HOMA-IR in predicting the prognosis of TBI patients was 0.888, which was higher than them alone (P < 0.05). Conclusions Increased ApoB/ApoA1 ratio and TyG index in the elderly patients with TBI are associated with aggravated nerve injury and poor prognosis. Detection of ApoB/ApoA1 ratio and TyG index is helpful to assess the risk of poor prognosis in the elderly patients with TBI.

Key words: traumatic brain injury, insulin resistance, triglyceride-glucose index, apolipoprotein B, apolipoprotein A1, prognosis

中图分类号:

R 651.1

李光耀, 叶碧华, 李小靓, 汤秦, 刘翠华. ApoB/ApoA1比值、甘油三酯-葡萄糖指数与老年创伤性脑损伤严重程度和预后的关系[J]. 实用老年医学, 2024, 38(10): 1049-1053.

LI Guangyao, YE Bihua, LI Xiaoliang, TANG Qin, LIU Cuihua. Relationship of ApoB/ApoA1 ratio and triglyceride glucose index with severity and prognosis of traumatic brain injury in the elderly[J]. Practical Geriatrics, 2024, 38(10): 1049-1053.

参考文献

[1] WANG K K, YANG Z, ZHU T, et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury[J]. Expert Rev Mol Diagn, 2018, 18(2):165-180.
[2] SEKAR S, VISWAS R S, MIRANZADEH M H, et al. Concussion/mild traumatic brain injury (TBI) induces brain insulin resistance: a positron emission tomography (PET) Scanning study[J]. Int J Mol Sci, 2021, 22(16):9005.
[3] HE H, FENG J, ZHANG S, et al. The apolipoprotein B/A1 ratio is associated with metabolic syndrome components, insulin resistance, androgen hormones, and liver enzymes in women with polycystic ovary syndrome[J]. Front Endocrinol: Lausanne, 2022, 12:773781.
[4] SELVI N M K, NANDHINI S, SAKTHIVADIVEL V, et al. Association of triglyceride-glucose index (TyG index) with HbA1c and insulin resistance in type 2 diabetes mellitus[J]. Maedica:Bucur, 2021, 16(3):375-381.
[5] LIU D, YANG K, GU H, et al. Predictive effect of triglyceride-glucose index on clinical events in patients with acute ischemic stroke and type 2 diabetes mellitus[J]. Cardiovasc Diabetol, 2022, 21(1):280.
[6] RIMEL R W, JANE J A, EDLICH R F. An injury severity scale for comprehensive management of central nervous system trauma[J]. JACEP, 1979, 8(2):64-67.
[7] WANG L, CONG H L, ZHANG J X, et al. Triglyceride-glucose index predicts adverse cardiovascular events in patients with diabetes and acute coronary syndrome[J]. Cardiovasc Diabetol, 2020, 19(1):80.
[8] NORDBY H K, NESBAKKEN R. The effect of high dose barbiturate decompression after severe head injury. A controlled clinical trial[J]. Acta Neurochir: Wien, 1984, 72(3/4):157-166.
[9] POMYTKIN I, PINELIS V. Brain insulin resistance: focus on insulin receptor-mitochondria interactions[J]. Life: Basel, 2021, 11(3):262.
[10] CAO C, WANG H, GAO H, et al. Insulin resistance is associated with an unfavorable outcome among non-diabetic patients with isolated moderate-to-severe traumatic brain injury - a propensity score-matched study[J]. Front Neurol, 2022, 13:949091.
[11] KORKMAZ N, KESIKBURUN S, ATAR M Ö, et al. Insulin resistance and related factors in patients with moderate and severe traumatic brain injury[J]. Ir J Med Sci, 2023, 192(3):1177-1182.
[12] NURTAZINA A, KOZHAKHMETOVA D, DAUTOV D, et al. Apolipoprotein B/A1 ratio as a diagnostic alternative to triglycerides and HDL-cholesterol for the prediction of metabolic syndrome among hypertensives in Kazakhstan[J]. Diagnostics: Basel, 2020, 10(8):510.
[13] 马宁果, 何涛, 刘甜甜. 脂质蓄积指数与血清ApoB/ApoA1比值对多囊卵巢综合征合并代谢综合征的预测价值[J]. 蚌埠医学院学报, 2022, 47(2):202-206.
[14] TOHIDI M, BAGHBANI-OSKOUEI A, AHANCHI N S, et al. Fasting plasma glucose is a stronger predictor of diabetes than triglyceride-glucose index, triglycerides/high-density lipoprotein cholesterol, and homeostasis model assessment of insulin resistance: Tehran Lipid and Glucose Study[J]. Acta Diabetol, 2018, 55(10):1067-1074.
[15] YANG X, WANG G, JING J, et al. Association of triglyceride-glucose index and stroke recurrence among nondiabetic patients with acute ischemic stroke[J]. BMC Neurol, 2022, 22(1):79.
[16] CHEN T, QIAN Y, DENG X. Triglyceride glucose index is a significant predictor of severe disturbance of consciousness and all-cause mortality in critical cerebrovascular disease patients[J]. Cardiovasc Diabetol, 2023, 22(1):156.

ApoB/ApoA1比值、甘油三酯-葡萄糖指数与老年创伤性脑损伤严重程度和预后的关系

Relationship of ApoB/ApoA1 ratio and triglyceride glucose index with severity and prognosis of traumatic brain injury in the elderly

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

推荐阅读 10

[1]	连芸, 蒋文, 朱方, 成语, 赵慧慧. 老年与年轻艾滋病相关淋巴瘤病人临床特点及预后分析[J]. 实用老年医学, 2024, 38(9): 920-925.
[2]	王新平, 谢柏梅, 卫国, 叶晓莉, 赵亚芸, 谭小田. 老年特发性间质性肺炎病人血清S100A9及sCD163表达水平及临床意义[J]. 实用老年医学, 2024, 38(8): 802-807.
[3]	薛冰艳, 徐瑞彤, 顾丹阳, 朱国琴. 81例老年胰腺神经内分泌肿瘤病人的临床病理特征与预后相关性分析[J]. 实用老年医学, 2024, 38(7): 718-721.
[4]	陈吐芬, 张波. 50例老年戊型肝炎临床特点与血清学特征分析[J]. 实用老年医学, 2024, 38(7): 722-726.
[5]	杨绍孔, 陈立文, 沈华, 张铮. 脓毒症心肌病诊断及预后标志物的研究进展[J]. 实用老年医学, 2024, 38(7): 748-752.
[6]	杜招娜, 姜文博, 牟俊宇, 俞成云, 夏伟. 经导管主动脉瓣置换术后新发持续完全性左束支传导阻滞的危险因素及短期预后分析[J]. 实用老年医学, 2024, 38(5): 500-437.
[7]	肖文, 胡秀, 李隽, 宋斌. 中性粒细胞/淋巴细胞比值与老年维持性血液透析病人预后的关系[J]. 实用老年医学, 2024, 38(4): 372-376.
[8]	胡芸, 汪曙红, 徐骥. 系统免疫炎症指数、白蛋白、甲胎蛋白与老年胃腺癌肝转移病人预后的相关性研究[J]. 实用老年医学, 2024, 38(4): 377-381.
[9]	王慧娟, 李霞. 主观认知下降转归为阿尔茨海默病的研究现状[J]. 实用老年医学, 2024, 38(4): 414-417.
[10]	彭泽通, 张尧, 刘斌. 贫血对老年社区获得性肺炎死亡的影响分析[J]. 实用老年医学, 2024, 38(3): 260-264.
[11]	陈璐, 姚俊英, 俞永贇, 范旻. MDT免疫营养支持治疗在老年颅脑手术病人中的应用效果[J]. 实用老年医学, 2024, 38(3): 278-282.
[12]	朱武刚, 翟晨彤, 刘德干, 徐文静. 外周血中性粒细胞与淋巴细胞比值对老年转移性食管癌免疫治疗预后的影响[J]. 实用老年医学, 2024, 38(2): 171-175.
[13]	张明, 陈曦, 刘跃洪, 谢德, 王志聪, 兰平文, 王光林. 红细胞体积分布宽度与老年髋部骨折病人预后的关系[J]. 实用老年医学, 2024, 38(1): 22-27.
[14]	孙洁, 查秀芳, 徐瑾, 赵君宁, 何伟, 张楠楠. 胃癌病人AHNAK表达与巨噬细胞浸润及预后的相关性[J]. 实用老年医学, 2024, 38(1): 49-53.
[15]	李晓宇, 刘城墙, 张尚鑫, 周利民. 120例短暂性脑缺血发作患者ABCD2评分与血清超敏C反应蛋白的相关性[J]. 实用老年医学, 2015, 29(5): 384-.