Journal of Capital Medical University ›› 2026, Vol. 47 ›› Issue (1): 37-42.doi: 10.3969/j.issn.1006-7795.2026.01.005

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Association of cholesterol, high-density lipoprotein, and glucose index with stroke recurrence in patients with ischemic stroke or transient ischemic attack: a nationwide registry-based cohort study

Dong Liping1, Li Xinya2,3,4,5, Jing Jing2,3,4,5, Xia Xue2,3,4,5, Gao Meng2,3,4,5, Tian Xue2,3,4,5, Zhang Yijun2,3,4,5, Wang Anxin2,3,4,5*   

  1. 1.Department of Neurology, Beijing Daxing District People’s Hospital, Beijing 102600, China；2.Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China；3.National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China；4.Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing 100070, China；5.Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
  • Received:2025-10-20 Revised:2025-11-04 Online:2026-02-21 Published:2026-02-02
  • Supported by:
    This study was supported by National Key Research and Development Program of China (2022YFC3600600).

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Abstract: Objective  To systematically analyze the associations between the cholesterol, high-density lipoprotein, and  fasting blood glucose (CHG) index and stroke recurrence as well as other adverse outcomes in patients with ischemic stroke or transient ischemic attack (TIA).Methods  The data source for this study was the  China National Stroke Registry-Ⅲ (CNSR-Ⅲ）. Patients with ischemic stroke or TIA within 7 d of onset were included. The exposure factor was the baseline CHG index. The study population was grouped according to the quartiles of the CHG index, designated as Q1, Q2, Q3, and Q4. The primary outcome measure was stroke recurrence within 1 year. The Cox proportional hazards model was employed to analyze the relationship between the CHG index and the outcomes, and the hazard ratio (HR) and 95% confidence intervals (CI) were calculated. A total of four models were constructed.Results  A total of 11 946 patients were included in the analysis. The median (interquartile range) age of the patients was 62 (54, 70) years, and 8 126 (68.02%) patients were male. Compared with the Q1 group, the Q2, Q3, and Q4 groups were all associated with a higher risk of stroke recurrence. In Model 4, the HR (95% CI) were 1.38 (1.08-1.77), 1.46 (1.15-1.87), and 1.44 (1.12-1.86), respectively. When the CHG index was treated as a continuous variable, the association remained statistically significant.Conclusion  The CHG index is positively associated with stroke recurrence in patients with ischemic stroke or TIA. In clinical practice, it is advisable to pay more attention to patients with abnormal lipid and blood glucose levels and strengthen the implementation and adherence to secondary prevention measures to reduce stroke recurrence.

Key words: cholesterol, high-density lipoprotein, glucose, ischemic stroke, transient ischemic attack, stroke recurrence

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