1.Relation between NEW-TOAST classification and glucose level in patients with acute ischemic stroke
Chengguo ZHANG ; Guohua ZHANG ; Shuyun HUANG
Chinese Journal of Neurology 2011;44(10):681-684
ObjectiveTo investigate the relation between each subtype of cerebral ischemic stroke classified by NEW-TOAST criteria and the levels of blood sugar. MethodsA retrospective study in 624 patients hospitalized with acute cerebral ischemic stroke. All the patients were classified using NEW-TOAST classification standard. Blood glucose in patients with different stroke subtypes was recorded, and analyzed for the incidence of abnormal glucose metabolism in each subtype. The correlation of glucose to blood sugar,blood pressure and blood fat was analyzed using odd ratio (OR) and 95% confidence intervals (CI).Results(1) Among 624 patients, the most common stroke subtype by NEW-TOAST classificationis atherothrombosis (AT), followed by small arterial occlusion (SAO). One hundred and nineteen patients (19. 1% ) had diabetes history; another 40 patients(7.5% ) were newly diagnosed with diabetes in this study; and 71 patients ( 11.4% ) were found to have glycoregulation abnormality. The incidence of abnormal glycometabolism was high in patients with AT ( 40. 4% ) and SAO ( 39. 7% ). ( 2 ) Association analysis between stroke subtypes and blood sugar: x2 =14. 83,P =0. 020, r =0. 152; in SAO patients, OR was 1. 925 (95% CI 1. 392-2. 664) ; in the patients with AT, there was no correlation to blood sugar levels.Association analysis of high blood pressure in stroke subtypes: in AT patients, OR was 2. 874 (95% CI 1. 957-4. 222) ; in SAO, OR was 1. 609 (95% CI 1. 100-1. 235). Association analysis of high LDL-C in each subtype: OR in SAO was 1.419 (95% CI 1.026-1. 962) ;No significant correlation of LDL-C in AT patients, P =0. 929 ; (3) There is significant difference of frequency of abnormal glycometabolism between stroke subtypes: x2 =17. 79 ,P =0. 000; between AT and SAO patients, x2 =0. 024,P =0. 877; between AT or SAO patients to other three subtypes, P < 0. 05. ConclusionsAmong the subtypes of cerebral ischemic stroke by NEW-TOAST classification, AT and SAO are the most common subtypes.All the subtypes have correlation to the high level of blood sugar, and SAO has the highest correlation to blood sugar levels. High blood pressure may affect both large vessels and small vessels, while high LDL-C may mainly affect small vessels.
2.Association between nutrition and peripheral artery disease in continuous ambulatory peritoneal dialysis patients
Yue GU ; Chengguo HUANG ; Lei YAN ; Hui CHEN ; Bing LIU ; Fengmin SHAO
Chinese Journal of Nephrology 2014;30(8):580-585
Objective To investigate the association between nutrition and peripheral artery disease (PAD) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods One hundred and two stable CAPD patients from a single center were enrolled in this cross-sectional study.Automatic ankle-brachial index (ABI) measuring system was applied to examine ABI.Patients were divided into PAD group (ABI < 0.9) and non-PAD group (ABI≥0.9).Clinical data were collected.Biochemical parameters were detected.Nutritional status was evaluated by serum albumin,handgrip strength (HGS) and subjective global assessment (SGA).Logistic regression analysis was performed to estimate the association of PAD with each nutritional marker as well as other potential risk factors.Results The incidence of PAD was 23.53% (24/102).ABI was significantly lower in patients with malnutrition as compared to those without malnutrition [(0.72 ± 0.21) vs (1.04 ± 0.14),P<0.01].Compared with non-PAD patients,serum albumin (P < 0.01),HGS (P < 0.01),diastolic blood pressure (P < 0.05),serum creatine (P < 0.05)、blood urine nitrogen (P < 0.01) were significantly decreased,but age (P < 0.01),the incidence of malnutrition [SGA,P < 0.01],diabetic status (P < 0.01),cardiovascular disease history (P < 0.01) were significantly increased in PAD patients.Logistic regression analysis showed that serum albumin (OR=0.762,95% CI:0.611-0.948,P=0.015),HGS (OR=0.988,95% CI:0.979-0.997,P=0.013) were independent protective factors for PAD,malnutrition [(SGA),OR=21.101,95% CI:5.008-88.901,P<0.01] was independent risk factor for PAD in CAPD patients.Conclusions The PAD incidence of CAPD patients in our center is 23.53%.Nutrition is independent factor associated with PAD in CAPD patients.
3.Effect of age-related white matter changes on long-term first symptomatic ischemic stroke events in the oldsters
Shuyun HUANG ; Jiancong LU ; Chengguo ZHANG ; Guode LI ; Yukai WANG ; Guohua ZHANG ; Jianping LIU ; Yanyun FENG ; Weiping ZHANG ; Biqing LIN ; Haiqun XIE
Chinese Journal of Neuromedicine 2019;18(7):700-704
Objective To study the effect of age-related white matter changes (ARWMC) on first symptomatic ischemic stroke events in the oldsters. Methods For the prospective study, a total of 368 eligible oldsters were enrolled in the study from January 2010 to August 2012. The degrees of ARWMC were assessed by ARWMC scale;according to the scores, they were divided into non ARWMC group, mild-moderate ARWMC group and severe ARWMC group. The patients were followed up once every 3 months. The clinical endpoint events and time (first symptomatic ischemic stroke, myocardial infarction and all-cause death) were recorded. Analyses of variance and Chi-square test were used to compare the differences of clinical data among the 3 groups. COX regression was used to assess the risk differences of first symptomatic ischemic stroke in the oldsters of three groups. Results After an average of follow-up for 48.7 months, 50 participants (13.6%) had first symptomatic ischemic stroke;25 (25.8%) were categorized as the severe ARWMC group, 22 (10.9%) were as the mild-medium group, and 3 (4.4%) were as the non ARWMC group. Among the three groups, the differences in age, history of hypertension, systolic blood pressure, incidence of clinical endpoint events and first symptomatic ischemic stroke, and follow-up time of endpoint events were statistically significant (P<0.05); patients from the severe ARWMC group were the oldest, and had the longest history of hypertension, the highest systolic blood pressure, the highest incidence of clinical end events and first symptomatic ischemic stroke, and the shortest follow-up period for clinical end events. COX regression analysis showed that the risk of first symptomatic ischemic stroke in the severe ARWMC group was about 8 times higher than that in the non ARWMC group (hazard ratio=9.012, 95%CI: 2.310-35.154, P=0.002). Conclusion In oldsters, severe ARWMC often accompany hypertension history and poor blood pressure controll, and it is an independent and serious risk factor for long-term first symptomatic ischemic stroke.