PDF(Pubmed)
Abstract：
BACKGROUND: Glycated albumin (GA) is an indicator of glycemic variability over the past 2-4 weeks and has suitable characteristics for predicting the prognosis of ischemic stroke during the acute phase. This study evaluated the association between early neurological deterioration (END) and GA values in patients with acute ischemic stroke (AIS).
METHODS: We assessed consecutive patients with AIS between 2022 and 2023 at two large medical centers in Korea. END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. We evaluated various glycemic parameters including fasting glucose (mg/dL), hemoglobin A1c (%), and GA (%).
RESULTS: In total, 531 patients with AIS were evaluated (median age: 69 years, male sex: 66.3%). In the multivariable logistic regression analysis, GA value was positively associated with END (adjusted odds ratio [aOR] = 3.24, 95% confidence interval [CI]: 1.10-9.50). Initial NIHSS score (aOR = 1.04, 95% CI: 1.01-1.08) and thrombolytic therapy (aOR = 2.06, 95% CI: 1.14-3.73) were also associated with END. In a comparison of the predictive power of glycemic parameters for END, GA showed a higher area under the curve value on the receiver operating characteristic curve than fasting glucose and hemoglobin A1c.
CONCLUSIONS: High GA values were associated with END in patients with AIS. Furthermore, GA was a better predictor of END than fasting glucose or hemoglobin A1c.
METHODS: We assessed consecutive patients with AIS between 2022 and 2023 at two large medical centers in Korea. END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. We evaluated various glycemic parameters including fasting glucose (mg/dL), hemoglobin A1c (%), and GA (%).
RESULTS: In total, 531 patients with AIS were evaluated (median age: 69 years, male sex: 66.3%). In the multivariable logistic regression analysis, GA value was positively associated with END (adjusted odds ratio [aOR] = 3.24, 95% confidence interval [CI]: 1.10-9.50). Initial NIHSS score (aOR = 1.04, 95% CI: 1.01-1.08) and thrombolytic therapy (aOR = 2.06, 95% CI: 1.14-3.73) were also associated with END. In a comparison of the predictive power of glycemic parameters for END, GA showed a higher area under the curve value on the receiver operating characteristic curve than fasting glucose and hemoglobin A1c.
CONCLUSIONS: High GA values were associated with END in patients with AIS. Furthermore, GA was a better predictor of END than fasting glucose or hemoglobin A1c.
摘要：
背景：糖化白蛋白（GA）是过去2-4周血糖变异性的指标，具有预测急性期缺血性卒中预后的合适特征。这项研究评估了急性缺血性卒中（AIS）患者早期神经功能恶化（END）与GA值之间的关系。
方法：我们在韩国的两个大型医疗中心评估了2022年至2023年期间AIS的连续患者。END定义为在入院的前72小时内，美国国立卫生研究院卒中量表（NIHSS）总评分增加≥2分或运动NIHSS评分增加≥1分。我们评估了各种血糖参数，包括空腹血糖（mg/dL），血红蛋白A1c（%），GA（%）。
结果：总计，对531例AIS患者进行了评估（中位年龄：69岁，男性：66.3%）。在多变量逻辑回归分析中，GA值与END呈正相关(校正比值比[aOR]=3.24,95%置信区间[CI]:1.10-9.50)。初始NIHSS评分（aOR=1.04，95％CI：1.01-1.08）和溶栓治疗（aOR=2.06，95％CI：1.14-3.73）也与END相关。在对END的血糖参数的预测能力的比较中，GA在受试者工作特征曲线上显示出比空腹血糖和血红蛋白A1c更高的曲线下面积。
结论：高GA值与AIS患者的END相关。此外，GA比空腹血糖或血红蛋白A1c更好地预测END。
方法：我们在韩国的两个大型医疗中心评估了2022年至2023年期间AIS的连续患者。END定义为在入院的前72小时内，美国国立卫生研究院卒中量表（NIHSS）总评分增加≥2分或运动NIHSS评分增加≥1分。我们评估了各种血糖参数，包括空腹血糖（mg/dL），血红蛋白A1c（%），GA（%）。
结果：总计，对531例AIS患者进行了评估（中位年龄：69岁，男性：66.3%）。在多变量逻辑回归分析中，GA值与END呈正相关(校正比值比[aOR]=3.24,95%置信区间[CI]:1.10-9.50)。初始NIHSS评分（aOR=1.04，95％CI：1.01-1.08）和溶栓治疗（aOR=2.06，95％CI：1.14-3.73）也与END相关。在对END的血糖参数的预测能力的比较中，GA在受试者工作特征曲线上显示出比空腹血糖和血红蛋白A1c更高的曲线下面积。
结论：高GA值与AIS患者的END相关。此外，GA比空腹血糖或血红蛋白A1c更好地预测END。
