Relationship Between Carotid Atherosclerosis And Estimated Glomerular Filtration Rate In Patients With Acute Ischemic Stroke

Objective At present,the relationship between carotid atherosclerosis and estimated glomerular filtration rate(e GFR)in different populations has not been fully clarified at home and abroad,and previous studies have mostly focused on hypertension and diabetes.There are few studies on acute ischemic stroke(AIS).On the basis of collecting and analyzing the data of AIS patients,this paper discusses the relationship between carotid atherosclerosis and e GFR in patients with AIS,in order to provide reference for clinical evaluation of carotid atherosclerosis and provide new ideas for the prevention of carotid atherosclerosis.MethodsA total of 217 AIS patients who were hospitalized for the first time in the Department of Neurology,Yixing Hospital Affiliated to Jiangsu University from October 2020 to April 2021 were selected as the research objects.The baseline data of patients at admission were collected and e GFR was calculated using the CKD-EPI formula.According to the results of carotid ultrasound,they were divided into normal carotid group(73 cases)and carotid atherosclerosis group(144 cases).Compared with the baseline data between the two groups,the correlation between e GFR level and carotid intima-media thickness(IMT)and the incidence of carotid atherosclerotic plaque was analyzed.Univariate Logistic regression was used to analyze the factors affecting the occurrence of carotid atherosclerosis in patients with AIS.Multivariate Logistic regression was used to analyze the relationship between e GFR level and carotid atherosclerosis.Propensity score match(PSM)was used to match the two groups of data to remove the influence of confounding factors.To compare the relationship between carotid atherosclerosis and e GFR in AIS patients of different genders.Finally,the receiver operating characteristic curve(ROC)was used to test the efficacy of e GFR in assessing carotid atherosclerosis in patients with AIS.Results1.A total of 217 AIS patients were included in this study,including 128 males(59.0%)and 89 females(41.0%).The mean age was 65.94±11.39 years.There were 158(72.8%)patients with a history of smoking,24(11.1%)patients with a history of alcohol consumption,78(35.9%)patients with a history of hypertension,and 27(12.4%)patients with a history of diabetes.2.The baseline data of the two groups showed that compared with the normal carotid artery group,the proportion of patients with hypertension history in the carotid atherosclerosis group was higher,the age was older,and the e GFR level was lower.The differences were statistically significant(P<0.05).There were no significant differences in male proportion,drinking history,smoking history,diabetes history,body mass index,total cholesterol,low density lipoprotein,high density lipoprotein,triglyceride,fasting blood glucose and uric acid between the two groups(P>0.05).3.Correlation analysis showed that e GFR level was negatively correlated with IMT(r=-0.471,P<0.001)and the incidence of carotid atherosclerotic plaque(r=-0.388,P<0.001).4.The binary logistic regression model was established with the presence of carotid atherosclerosis in AIS patients as the dependent variable and age,male proportion,drinking history,smoking history,diabetes history,hypertension history,triglyceride,total cholesterol,low density lipoprotein,high density lipoprotein and e GFR as independent variables.Univariate logistic regression results showed that age(OR=1.099,95%CI:1.065-1.135),history of hypertension(OR=1.973,95%CI:1.062-3.665),e GFR(OR=0.909,95%CI:0.879-0.940)were correlated with carotid atherosclerosis(P<0.05).Further multivariate Logistic regression analysis showed that age(OR=1.055,95%CI:1.012-1.099)and decreased e GFR(OR=0.944,95%CI:0.906-0.984)were independent risk factors for carotid atherosclerosis in AIS patients(P<0.05).5.After PSM treatment,59 cases of normal carotid artery group and 59 cases of carotid atherosclerosis group were selected.There were no significant differences in age,male,smoking history,drinking history,hypertension history,diabetes history,body mass index,total cholesterol,high density lipoprotein,low density lipoprotein,triglyceride,fasting blood glucose and uric acid between the two groups(P>0.05).The level of e GFR in carotid atherosclerosis group was still lower than that in normal carotid group(P<0.001).6.The subgroup analysis of AIS patients of different genders showed that there was a correlation between carotid atherosclerosis and e GFR in AIS patients of different genders(P<0.05).7.The efficacy of e GFR in evaluating carotid atherosclerosis in AIS patients by ROC curve test showed that the area under ROC curve was 0.774(95%CI:0.712-0.836),the cut-off value was 96.83 m L/(min·1.73m2),the specificity was 74.3%,and the sensitivity was 71.2%.ConclusionsThe level of e GFR in AIS patients is negatively correlated with carotid atherosclerosis.The decrease of e GFR level is a risk factor for carotid atherosclerosis in patients with AIS.e GFR is expected to be an important indicator for clinical evaluation of carotid atherosclerosis in patients with AIS.