Association between triglyceride-glucose index and intracranial/extracranial atherosclerotic stenosis: findings from a retrospective study.

OBJECTIVE: The association of the triglyceride-glucose (TyG) index with intracranial atherosclerotic stenosis (ICAS) and extracranial atherosclerotic stenosis (ECAS) is unclear. This study aimed to investigate the relationship of TyG index with the distribution and severity of ICAS and ECAS. METHOD: Patients who underwent digital subtraction angiography (DSA) for evaluating ICAS/ECAS in Zhongnan Hospital of Wuhan University from January 2017 to October 2021 were retrospectively enrolled in our study. Clinical characteristics, DSA data, blood routine, lipid profile and fasting glucose were recorded. The association of TyG index and ICAS/ECAS status were investigated in four aspects: location and distribution of stenosis, stenosis severity and whether stenosis is symptomatic. Logistic regression models were used to evaluate the association. Restricted cubic splines were constructed to model the non-linear relationship between the TyG index and different arterial stenosis status. RESULTS: Among 1129 included patients, the median age was 62 (IQR 55-68) years, and 71.3% were male. The median TyG index was 8.81 (8.40, 9.21). Elevated TyG index was significantly associated with ICAS, combined ICAS/ECAS, anterior circulation stenosis, posterior circulation stenosis, combined anterior/posterior circulation stenosis, severe stenosis, both asymptomatic and symptomatic stenosis. This association was maintained after adjusting for age, sex, smoking, drinking, medical history of hypertension and stroke, platelet, total cholesterol, high-density lipoprotein, and low-density lipoprotein. Multivariable-adjusted spline regression models showed that a progressively increasing risk of arterial stenosis was related to an elevated TyG index. CONCLUSION: Elevated TyG index was associated with ICAS/ECAS. TyG index might be a useful indicator of ICAS and severe stenosis.

Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis.

Background: Neutrophil-to-lymphocyte ratio (NLR) has been shown to be an important inflammatory maker. This study aims to investigate the association of NLR with intracranial and extracranial atherosclerotic stenosis. Methods: We retrospectively recruited patients who underwent digital subtraction angiography (DSA) for evaluating intracranial/extracranial stenosis in the Zhongnan Hospital of Wuhan University from January 2017 to October 2021. Clinical characteristics, DSA data, blood routine, and lipid profile were recorded. Logistic regression was used to evaluate the association of NLR and intercranial/extracranial atherosclerotic stenosis in three aspects: distribution of stenosis, whether the stenosis is symptomatic, and degree of stenosis. Results: A total of 1,129 patients were included in our analysis, with a median age of 62 y (interquartile range 55-68), and a median admission NLR of 2.39 (interquartile range 1.84-3.42). A total of 986 patients presented intracranial and/or extracranial atherosclerotic stenosis. Increased NLR were associated with intracranial stenosis [odds ratio (OR), 1.54; 95% CI, 1.27-1.85; p < 0.001], extracranial stenosis (OR, 1.56; 95% CI, 1.25-1.96; p < 0.001), and combined intracranial/extracranial stenosis (OR, 1.61; 95% CI, 1.28-2.03; p < 0.001). After adjustment of potential factors, higher NLR were independently associated with symptomatic stenosis (OR, 1.16; 95% CI, 1.05-1.27; p = 0.003) and degree of stenosis (OR, 1.32; 95% CI, 1.17-1.49; p < 0.001). Compared with the first quartile NLR, the second, third, and fourth quartiles NLR were independent risk factors for symptomatic stenosis and stenosis degree (both p for trend <0.001). Conclusion: Increased NLR is an important factor associated with both intracranial and extracranial atherosclerotic stenosis. Patients with symptomatic intracranial/extracranial atherosclerotic stenosis or a more severe degree of stenosis presented elevated NLR levels.

Influencing factors of cerebral atherosclerotic stenosis in patients with ischemic stroke in Kashgar / 国际脑血管病杂志

Objective:To investigate the related factors of cerebral atherosclerotic stenosis in patients with ischemic stroke in Kashgar.Methods:Patients with ischemic stroke treated in the Department of Neurology, the First People’s Hospital of Kashgar Prefecture from January 2013 to September 2019 were retrospectively enrolled. According to the findings of head and neck angiography, they were divided into without artery stenosis group, only intracranial artery stenosis group, only extracranial artery stenosis group, and intracranial + extracranial artery stenosis group. Demographic and clinical data were compared among the groups. Multivariate logistic regression analysis was used to determine the independent risk factors for cerebral atherosclerotic stenosis. Results:A total of 2 054 patients with ischemic stroke were enrolled. Their age was 60.73±11.36 years, and 1 213 were men (59.1%). There were 973 patients (47.4%) in the without artery stenosis group, 493 (24.0%) in the only intracranial artery stenosis group, 367 (17.9%) in the only extracranial artery stenosis group, and 221 (10.8%) in the intracranial + extracranial artery stenosis group. The comparison among the groups showed that there were significant differences in age, hypertension, diabetes, coronary heart disease, lymphocyte count, leukocyte count, neutrophil count, blood sodium, blood magnesium, fructosamine, fasting blood glucose, albumin, globulin, low-density lipoprotein cholesterol, apolipoprotein B, apolipoprotein A, hypersensitive C-reactive protein, fibrinogen, and neutrophil-to-lymphocyte ratio. Multivariable logistic regression analysis showed that compared with the without arterial stenosis, older age (odds ratio [ OR] 1.01, 95% confidence interval [ CI] 1.003-1.02; P=0.011) and higher neutrophil count ( OR 1.11, 95% CI 1.06-1.16; P<0.001) were the independent risk factors for intracranial arterial stenosis; older age ( OR 1.04, 95% CI 1.02-1.05; P<0.001), complicated with coronary heart disease ( OR 1.43, 95% CI 1.00-2.04; P=0.048), higher low-density lipoprotein cholesterol ( OR 1.22, 95% CI 1.05-1.42; P=0.011) and fibrinogen (OR 1.26, 95% CI 1.07-1.47; P=0.004) were the independent risk factors for extracranial artery stenosis, and older age ( OR 1.06, 95% CI 1.05-1.08; P<0.001), complicated hypertension ( OR 1.85, 95% CI 1.27-2.69; P=0.001) and diabetes ( OR 1.80, 95% CI 1.22-2.66; P=0.003), higher neutrophil count ( OR 1.10, 95% CI 1.02-1.17; P=0.008), fructosamine ( OR 1.36, 95% CI 1.05-1.78; P=0.022) and low-density lipoprotein cholesterol ( OR 1.24, 95% CI 1.02-1.51; P=0.034) were the independent risk factors for intracranial + extracranial artery stenosis. Conclusion:There are some differences in the risk factors for intracranial and extracranial artery stenosis in patients with ischemic stroke in Kashgar Prefecture.

Adiponectin-Transfected Endothelial Progenitor Cells Have Protective Effects After 2-Hour Middle-Cerebral Artery Occlusion in Rats With Type 2 Diabetes Mellitus.

Objectives: This present study aimed to examine the effects of adiponectin-transfected endothelial progenitor cells (LV-APN-EPCs) on cerebral ischemia-reperfusion injury in rats with type 2 diabetes mellitus (T2DM) and to explore the underlying mechanisms. Methods: Seventy male Sprague-Dawley rats with T2DM were randomly divided into sham, phosphate-buffered saline (PBS), LV-APN-EPCs, LV-EPCs, and EPCs groups. Transient middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method. After 1 h of reperfusion, the five interventions were performed by tail-vein injections. The modified neurological severity score (mNSS) was used to assess neurological function before and on days 1, 7, and 14 after MCAO. After 14 days, magnetic resonance imaging scanning, hematoxylin and eosin staining, terminal dUTP nick-end labeling staining, Western blotting analysis, cluster of differentiation (CD) 31 immunofluorescence, and enzyme-linked immunosorbent assay were used to evaluate infarct rate, morphological damage, cell apoptosis, and microvessel density. Results: Compared with PBS, LV-EPCs, and EPCs groups, the LV-APN-EPCs group showed significantly lower mNSS score, lower infarct rate, and less morphological damage (all P < 0.05). In addition, compared with other groups, the LV-APN-EPCs group had significantly increased levels of B cell lymphoma/leukemia-2 (Bcl-2) protein, CD31+ microvessels, endothelial nitric oxide synthase, and vascular endothelial growth factor, and decreased levels of Bcl-2-associated X protein and neuronal apoptosis in the peri-infarct cortex (all P < 0.05). Conclusion: These results suggest that LV-APN-EPCs exert protective effects against cerebral ischemia-reperfusion injury in T2DM rats by increasing angiogenesis.