Correlation Of Blood Trimethylamine Oxide(TMAO) Expression Level And Triglyceride Glucose Index With Acute Ischemic Stroke

Objective:Trimethylamine oxide(trimethylamine-N-oxide,TMAO)is a newly discove red intestinal microflora-dependent metabolite,which can lead to a variety of d iseases,such as diabetes,atherosclerosis,and cardio-cerebrovascular diseases.Tr iglyceride glucose index(triglyceride glucose index,TyG)is a potential marker of insulin resistance(IR)and an important risk factor for cardiovascular and cerebrovascular diseases.However,there are few studies on the relationship bet ween TMAO level and TyG index in patients with ischemic stroke.Therefore,to investigate the relationship between trimethylamine oxide(TMAO)expression,triglyceride glucose index,and trimethylamine oxide in patients with acute isc hemic stroke.Methods:Patients who suffered from acute ischemic stroke for the first time from November 2020 to December 2021 and were hospitalized in the Department of Neurology,Affiliated Hospital of Guizhou Medical University,and finally diagnosed with aortic atherosclerosis by TOAST classification were included in the case group,while non-stroke patients hospitalized in the same period were included as the control group.The strict screening was carried out according to the inclusion criteria and exclusion criteria.Relevant clinical baseline data of qualified patients were collected,and relevant tests were improved.Blood samples of all selected patients were collected within 24 hours of admission.TyG index was calculated by fasting blood glucose and fasting blood lipid,according to the TyG index,the patients in the case group were divided into low TyG(L-TyG)group(TyG < 8.70,n=54),medium TyG(M-TyG)group(8.70 ≤ TyG < 9.25,n=55),and high TyG(H-TyG)group(TyG ≥9.25,n=54).Enzyme-linked immunosorbent assay(ELISA)was used to analyze the trimethylamine oxide levels in the case group and the control group.Spearman’s rank correlation analysis or Pearson’s correlation analysis was used to understand the correlation between indicators,and multiple linear regression was used to analyze the factors influencing TMAO.Logistic regression analysis was used to explore the factors influencing the occurrence of ischemic stroke;the diagnostic value of TMAO,TyG index and the combination of both tests for CI was assessed by plotting the subject work characteristic(ROC)curve.The difference was considered statistically significant at P < 0.05.Results:1.patients in the case group had higher TMAO levels,and there was a statistical difference between TMAO levels and the control group(p<0.05);2.correlation analysis showed that TYG index,TG,and TMAO were significantly correlated(p<0.05)and positively correlated.3.sex(B=-4.871,P<0.05),diabetes(B=5.466,P<0.05),TyG index(B=10.816,P<0.05),had a statistically effect on TMAO(p<0.001),and the greater the TyG index,the greater the TMAO.TyG index is the influencing factor of blood TMAO level in patients with ischemic stroke.4.logistic regression analysis with whether ischemic stroke occurred as the dependent variable showed that hypertension,smoking,HDL,FBG,HCY,TyG index,and TMAO were risk factors for ischemic stroke(p < 0.05).5.ROC curve analysis showed that the area under the ROC curve for TMAO to predict ischemic stroke was 0.879 [95% CI(0.838,0.919)],p < 0.001,with the best cut-off value of 45.67 ppm,the sensitivity of 70.6%,and specificity of 91.5%.The best cut-off value for the TyG index was 8.93,p < 0.001.The best cut-off value for TMAO combined with the TyG index was 40.96,p < 0.001.TMAO alone and combined with the TyG index had better clinical value in the occurrence of ischemic stroke.Conclusions:TMAO and TyG index were significantly correlated and positively correlated;TyG index influenced the level of TMAO in patients with ischemic stroke;TyG index and higher levels of TMAO were risk factors for the occurrence of ischemic stroke;TMAO,TMAO and TYG index provide a new clinical basis and idea for the early diagnosis of patients with ischemic stroke.