Abstract:

Objective　To investigate the correlation of peripheral blood triglyceride glucose (TyG) index, serum homocysteine (Hcy), and folate metabolism genes with stroke. Methods　This was a case control study. Ninety-five patients with stroke treated at Xi'an Hospital of Traditional Chinese Medicine and Cerebral Diseases from February 2022 to February 2024 were selected as a study group, including 49 males and 46 females who were (59.96±4.92) years old. Ninety-five healthy examinees at Xi'an Hospital of Traditional Chinese Medicine and Cerebral Diseases in the same period were selected as a control group according to the ratio of 1:1, including 51 males and 44 females who were (59.95±4.85) years old. The clinical data of the two groups were collected. The peripheral blood TyG index, serum level of Hcy, and folate metabolism gene polymorphisms were detected. The risk factors for the development of stroke were analyzed. The statistical methods used were independent samples t test, χ² test, one-way analysis of variance, logistic regression analysis, and Hardy-Weinburg balance test. Results　The proportions of the patients with body mass index (BMI) ≥ 28 kg/m², hyperlipidemia, diabetes mellitus, hypertension, history of alcohol consumption, and smoking history, peripheral blood TyG index, and serum level of Hcy in the study group were higher than those in the control group [24.21% (23/95) vs. 7.37% (7/95), 25.26% (24/95) vs. 9.47% (9/95), 21.05% (20/95) vs. 8.42% (8/95), 48.42% (46/95) vs. 16.84% (16/95), 23.16% (22/95) vs. 9.47% (9/95), 28.42% (27/95) vs. 11.58% (11/95), 1.67±0.44 vs. 1.03±0.25, and (25.54±6.79) μmol/L vs. (10.22±2.16) μmol/L], with statistical differences (all P<0.05). The frequencies of TT genotype at MTHFR C677T locus and GG genotype at MTRR A66G locus in the study group were higher than those in the control group [42.11% (40/95) vs. 14.74% (14/95) and 38.95% (37/95) vs. 18.95% (18/95)], with statistical differences (both P<0.05). The logistic regression analysis showed that hyperlipidemia (OR=1.627), diabetes mellitus (OR=1.659), hypertension (OR=1.706), history of alcohol consumption (OR=1.637), history of smoking (OR=1.455), high peripheral blood TyG index (OR=1.510), high serum Hcy level (OR=1.820), and the TT genotype of the MTHFR C677T locus (OR=1.799) were the independent risk factors for the development of stroke (all P<0.05). Conclusion　Stroke is strongly associated with peripheral blood TyG index, high serum level of Hcy, and TT genotype at the MTHFR C677T locus.

Key words:

Stroke, Triglyceride-glucose index, Homocysteine, Folate, Gene polymorphisms

摘要：

目的　探讨外周血甘油三脂葡萄糖（TyG）指数、血清同型半胱氨酸（Hcy）及叶酸代谢基因多态性与脑卒中的相关性。方法　采用病例对照研究，选取西安中医脑病医院2022年2月至2024年2月收治的脑卒中患者95例作为研究组，男49例、女46例，年龄（59.96±4.92）岁，另外按照1∶1选取于本院同期接受健康体检的健康人群95名作为对照组，男51例、女44例，年龄（59.95±4.85）岁。收集两组研究对象的临床资料，并检测外周血TyG指数、血清Hcy水平及叶酸代谢基因多态性，同时分析脑卒中发病的危险因素。统计学方法采用独立样本t检验、χ²检验、单因素分析、logistic回归分析和Hardy-Weinburg平衡检验。结果　研究组体重指数（BMI）≥28 kg/m²、高血脂、糖尿病、高血压、饮酒史、吸烟史占比及外周血TyG指数、血清Hcy水平均高于对照组［24.21%（23/95）比7.37%（7/95）、25.26%（24/95）比9.47%（9/95）、21.05%（20/95）比8.42%（8/95）、48.42%（46/95）比16.84%（16/95）、23.16%（22/95）比9.47%（9/95）、28.42%（27/95）比11.58%（11/95）、1.67±0.44比1.03±0.25、（25.54±6.79）μmol/L比（10.22±2.16）μmol/L］，差异均有统计学意义（均P<0.05）。研究组5，10-亚甲基四氢叶酸还原酶（MTHFR）C677T位点TT基因型、甲硫氨酸合成酶还原酶（MTRR）A66G位点GG基因型频率［42.11%（40/95）、38.95%（37/95）］高于对照组［14.74%（14/95）、18.95%（18/95）］，差异均有统计学意义（均P<0.05）。Logistic回归分析结果显示，高血脂（OR=1.627）、糖尿病（OR=1.659）、高血压（OR=1.706）、饮酒史（OR=1.637）、吸烟史（OR=1.455）、外周血TyG指数偏高（OR=1.510）、血清Hcy水平偏高（OR=1.820）及MTHFR C677T位点TT基因型（OR=1.799）均是脑卒中发病的独立危险因素（均P<0.05）。结论　脑卒中与外周血TyG指数、血清Hcy水平偏高及MTHFR C677T位点TT基因型密切相关。

关键词:

脑卒中, 甘油三脂葡萄糖指数, 同型半胱氨酸, 叶酸, 基因多态性