Introduction
Methods
Study design
Data source
Study population
Variables
Three-month outcomes in patients with acute ischemic stroke
Covariates
Missing data processing
Statistical analysis
Results
Characteristics of participants
TG/HDL-ratio (quartile) | Q1(< 1.435) | Q2(1.435 to 2.125) | Q3(2.125 to 3.205) | Q4(≥ 3.205) | P-value |
---|---|---|---|---|---|
participants | 441 | 440 | 441 | 442 | |
HGB(g/dL) | 13.24 ± 1.82 | 13.56 ± 1.85 | 13.60 ± 1.93 | 13.64 ± 2.20 | 0.010 |
HCT(%) | 39.57 ± 5.06 | 40.33 ± 5.19 | 40.44 ± 5.36 | 40.38 ± 6.17 | 0.059 |
MCV(fl) | 93.29 ± 5.65 | 93.40 ± 5.28 | 92.92 ± 4.58 | 92.36 ± 5.25 | 0.013 |
PLT(10^9/L) | 218.56 ± 64.95 | 220.64 ± 69.24 | 222.61 ± 69.06 | 236.74 ± 77.58 | < 0.001 |
TC(mg/dl) | 176.74 ± 39.28 | 180.40 ± 43.62 | 177.46 ± 42.04 | 184.80 ± 46.73 | 0.022 |
TG(mg/dl) | 63.77 ± 15.23 | 88.20 ± 16.80 | 109.91 ± 23.56 | 167.31 ± 50.97 | < 0.001 |
HDL-c(mg/dl) | 60.28 ± 12.47 | 49.71 ± 9.85 | 42.16 ± 8.63 | 36.04 ± 8.03 | < 0.001 |
LDL-c(mg/dl) | 100.10 ± 33.30 | 110.58 ± 38.77 | 111.24 ± 36.08 | 113.33 ± 39.41 | < 0.001 |
BUN(mg/dl) | 15.00 (12.00–20.00) | 15.00 (12.00–20.00) | 16.00 (13.00–20.00) | 15.00 (12.00–20.00) | 0.655 |
Scr(mg/dl) | 0.85 (0.70–1.00) | 0.88 (0.73–1.08) | 0.90 (0.76–1.05) | 0.95 (0.76–1.16) | < 0.001 |
ALT(U/L) | 23.00 (19.00–29.00) | 23.00 (18.00–29.00) | 23.00 (19.00–29.00) | 23.00 (18.00–29.75) | 0.467 |
AST (U/L) | 17.00 (13.00–24.00) | 17.00 (12.75–25.00) | 19.00 (14.00–26.00) | 19.00 (14.00–29.00) | 0.090 |
ALB (g/dL) | 4.04 ± 0.36 | 4.04 ± 0.41 | 4.03 ± 0.43 | 4.00 ± 0.45 | 0.448 |
FBG(mmol/L) | 5.28 (4.67–6.28) | 5.44 (4.66–6.62) | 5.44 (4.83–6.44) | 5.44 (4.83–6.72) | 0.059 |
FIB (mg/L) | 321.96 ± 69.92 | 326.11 ± 78.89 | 333.42 ± 83.83 | 350.25 ± 94.70 | < 0.001 |
BMI (kg/m2) | 22.46 ± 2.99 | 23.22 ± 3.19 | 23.85 ± 3.20 | 24.47 ± 3.21 | < 0.001 |
Sex | < 0.001 | ||||
Male | 224 (50.79%) | 266 (60.45%) | 291 (65.99%) | 292 (66.06%) | |
Female | 217 (49.21%) | 174 (39.55%) | 150 (34.01%) | 150 (33.94%) | |
Age(years) | 0.006 | ||||
< 60 | 91 (20.63%) | 83 (18.86%) | 103 (23.36%) | 118 (26.70%) | |
60 to < 70 | 107 (24.26%) | 120 (27.27%) | 124 (28.12%) | 115 (26.02%) | |
70 to < 80 | 153 (34.69%) | 160 (36.36%) | 162 (36.73%) | 154 (34.84%) | |
≥ 80 | 90 (20.41%) | 77 (17.50%) | 52 (11.79%) | 55 (12.44%) | |
Previous stroke/TIA | 91 (20.63%) | 97 (22.05%) | 89 (20.18%) | 92 (20.81%) | 0.917 |
Hypertension | 261 (59.18%) | 282 (64.09%) | 284 (64.40%) | 289 (65.38%) | 0.222 |
DM | 106 (24.04%) | 135 (30.68%) | 147 (33.33%) | 163 (36.88%) | < 0.001 |
Smoking | 120 (27.21%) | 166 (37.73%) | 202 (45.80%) | 213 (48.19%) | < 0.001 |
CHD | 39 (8.84%) | 55 (12.50%) | 55 (12.47%) | 54 (12.22%) | 0.249 |
Stroke etiology | < 0.001 | ||||
SVO | 80 (18.14%) | 90 (20.45%) | 86 (19.50%) | 87 (19.68%) | |
LAA | 124 (28.12%) | 136 (30.91%) | 145 (32.88%) | 169 (38.24%) | |
CE | 142 (32.20%) | 119 (27.05%) | 103 (23.36%) | 84 (19.00%) | |
Other determined | 23 (5.22%) | 39 (8.86%) | 48 (10.88%) | 38 (8.60%) | |
Undetermined | 72 (16.33%) | 56 (12.73%) | 59 (13.38%) | 64 (14.48%) | |
NIHSS score | 0.273 | ||||
< 6 | 285 (64.63%) | 306 (69.55%) | 303 (68.71%) | 315 (71.27%) | |
6 to 13 | 93 (21.09%) | 82 (18.64%) | 93 (21.09%) | 84 (19.00%) | |
≥ 14 | 63 (14.29%) | 52 (11.82%) | 45 (10.20%) | 43 (9.73%) |
The incidence rate of unfavorable outcomes 3-month after acute ischemic stroke
TG/HDL ratio | Participants(n) | unfavorable outcome events (mRS score ≥ 3) | Incidence of unfavorable outcome (95% CI)(%) |
---|---|---|---|
Total | 1764 | 498 | 28.2(26.1–30.3) |
Q1 | 436 | 143 | 32.8(28.4–37.2) |
Q2 | 443 | 134 | 30.2(26.0–34.5) |
Q3 | 442 | 113 | 25.6(21.5–29.6) |
Q4 | 443 | 108 | 24.4 (20.4–28.4) |
P for trend | < 0.001 |
The results of univariate analyses using a binary logistic regression model
Variable | Characteristics | OR 95%CI | P |
---|---|---|---|
HGB(g/dl), mean ± sd | 13.510 ± 1.961 | 0.823 (0.780, 0.868) | < 0.001 |
HCT(%),mean ± sd | 40.177 ± 5.468 | 0.934 (0.916, 0.952) | < 0.001 |
MCV(fl), mean ± sd | 92.992 ± 5.215 | 0.985 (0.966, 1.005) | 0.146 |
PLT(10^9/L), mean ± sd | 224.648 ± 70.666 | 1.000 (0.998, 1.001) | 0.736 |
TC(mg/dl), mean ± sd | 179.853 ± 43.085 | 0.996 (0.994, 0.999) | 0.002 |
TG(mg/dl), mean ± sd | 107.344 ± 48.850 | 0.995 (0.993, 0.998) | < 0.001 |
HDL-c(mg/dl), mean ± sd | 47.040 ± 13.401 | 0.997 (0.989, 1.005) | 0.467 |
LDL-c(mg/dl), mean ± sd | 108.813 ± 37.292 | 0.998 (0.995, 1.001) | 0.112 |
BUN(mg/dl),median (quartile) | 16.000 (12.000–20.000) | 1.014 (1.002, 1.027) | 0.020 |
Scr(mg/dl),median (quartile) | 0.890 (0.740–1.070) | 0.992 (0.894, 1.101) | 0.875 |
ALT(U/L),median (quartile) | 23.000 (19.000–29.000) | 1.007 (0.999, 1.014) | 0.078 |
AST(U/L),median (quartile) | 18.000 (13.000–26.000) | 0.990 (0.982, 0.997) | 0.008 |
ALB (g/dL), mean ± sd | 4.029 ± 0.413 | 0.277 (0.213, 0.361) | < 0.001 |
FBG(mmol/L), mean ± sd | 5.920 ± 2.081 | 1.174 (1.118, 1.233) | < 0.001 |
TG/HDL-c ratio,median (quartile) | 2.128 (1.440–3.208) | 0.932 (0.869, 0.999) | 0.047 |
FIB (mg/L), mean ± sd | 332.946 ± 82.970 | 1.003 (1.002, 1.004) | < 0.001 |
BMI(kg/m2), mean ± sd | 23.499 ± 3.233 | 0.920 (0.890, 0.951) | < 0.001 |
Sex, n(%) | |||
Male | 1073 (60.828%) | Ref | |
Female | 691 (39.172%) | 1.747 (1.415, 2.156) | < 0.001 |
Age(years), n(%) | |||
< 60 | 395 (22.39%) | Ref | |
60 to < 70 | 466 (26.42%) | 1.301 (0.927, 1.826) | 0.128 |
70 to < 80 | 629 (35.66%) | 2.586 (1.931, 3.462) | < 0.001 |
≥ 80 | 203 (11.51% | 4.379 (3.085, 6.218) | < 0.001 |
Hypertension, n(%) | |||
NO | 648 (36.735%) | Ref | |
Yes | 1116 (63.265%) | 1.376(1.103, 1.716) | 0.005 |
DM, n(%) | |||
No | 1213 (68.764%) | Ref | |
Yes | 551 (31.236%) | 1.510 (1.213, 1.878) | < 0.001 |
Previous stroke/TIA, n(%) | |||
No | 1395 (79.082%) | Ref | |
Yes | 369 (20.918%) | 1.764 (1.384, 2.248) | < 0.001 |
NIHSS score, n(%) | |||
< 6 | 1209 (68.537%) | Ref | |
6 to 13 | 352 (19.955%) | 6.774 (5.193, 8.837) | < 0.001 |
≥ 14 | 203 (11.508%) | 17.026 (11.994, 24.170) | < 0.001 |
CHD, n(%) | |||
No | 1561 (88.492%) | Ref | |
Yes | 203 (11.508%) | 0.974 (0.702, 1.350) | 0.873 |
Stroke etiology, n(%) | |||
SVO | 343 (19.444%) | Ref | |
LAA | 574 (32.540%) | 1.659 (1.193, 2.306) | 0.003 |
CE | 448 (25.397%) | 2.351 (1.681, 3.289) | < 0.001 |
Other determined | 148 (8.390%) | 3.204 (2.093, 4.905) | < 0.001 |
Undetermined | 251 (14.229%) | 1.366 (0.916, 2.037) | 0.126 |
Smoking, n(%) | |||
No | 1063 (60.261%) | Ref | |
Yes | 701 (39.739%) | 0.604 (0.484, 0.752) | < 0.001 |
The results of multivariate analyses using the binary logistic regression model
Variable | Crude model (OR,95%CI) | P | Model I(OR,95%CI) | P | Model II(OR,95%CI) | P |
---|---|---|---|---|---|---|
TG/HDL-c ratio | 0.932 (0.869, 0.999) | 0.047 | 0.968 (0.901, 1.041) | 0.383 | 0.950 (0.869, 1.039) | 0.260 |
TG/HDL-c ratio (quartile) | ||||||
Q1(< 1.435) | Ref | Ref | Ref | |||
Q2(1.435 to 2.125) | 0.913 (0.687, 1.213) | 0.529 | 0.969 (0.722, 1.300) | 0.833 | 0.933 (0.658, 1.324) | 0.698 |
Q3(2.125 to 3.205) | 0.669 (0.498, 0.898) | 0.007 | 0.772 (0.570, 1.047) | 0.097 | 0.655 (0.453, 0.946) | 0.024 |
Q4(≥ 3.205) | 0.667 (0.497, 0.895) | 0.007 | 0.770 (0.568, 1.045) | 0.094 | 0.649 (0.444, 0.949) | 0.026 |
P for trend | 0.001 | 0.041 | 0.007 |
Sensitivity analysis
TG/HDL-c ratio | OR 95%CI | P-value |
---|---|---|
Model I | 0.902 (0.799, 1.017) | 0.093 |
Model II | 0.940 (0.843, 1.048) | 0.268 |
Model III | 0.990 (0.887, 1.104) | 0.856 |
Model IV | 0.922 (0.829, 1.026) | 0.136 |
The nonlinearity addressed by the generalized additive model
Unfavorable outcome: | OR(95%CI,) | P |
---|---|---|
Fitting model by standard linear regression | 0.950 (0.869, 1.039) | 0.2595 |
Fitting model by two-piecewise linear regression | ||
Inflection point of TG/HDL-c ratio | 3.515 | |
≤ 3.515 | 0.774 (0.656, 0.914) | 0.002 |
> 3.515 | 1.195 (1.004, 1.423) | 0.045 |
P for log-likelihood ratio test | 0.004 |