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Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke

  • Author Footnotes
    1 These authors contributed equally to this work.
    Mengyuan Miao
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China

    Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Yucong Bi
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Lijun Hao
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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  • Anran Bao
    Affiliations
    Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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  • Yaming Sun
    Affiliations
    Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, China
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  • Huaping Du
    Affiliations
    Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou 215200, China
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  • Liyan Song
    Affiliations
    Department of Neurology, The First People's Hospital of Taicang, Suzhou 215400, China
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  • Shoujiang You
    Correspondence
    Corresponding author. authors: Shoujiang You, MD, PhD,
    Affiliations
    Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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  • Chongke Zhong
    Correspondence
    Corresponding author. authors: PhD, Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu Province 215123, China. Telephone numbers:15106203120.
    Affiliations
    Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China

    Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
Published:November 07, 2022DOI:https://doi.org/10.1016/j.numecd.2022.11.004
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      Highlights

      • Patients with elevated TyG index had higher risk of unfavorable functional outcome at discharge and in-hospital mortality, implicating the significant short-term prognostic effect of TyG index in patients with ischemic stroke.
      • The TyG index provided incremental prognostic information for short-term unfavorable functional outcome over conventional risk factors.
      • Our study suggested that TyG index has implication in optimizing the risk stratification of short-term ischemic stroke outcomes to guide clinical decision.

      Abstract

      Background and aims

      The triglyceride-glucose (TyG) index has been demonstrated as an independent marker of ischemic stroke. Whether TyG index predicts short-term outcomes in patients with ischemic stroke remains uncertain. The aim of the study was to investigate the early prognosis value of TyG index in ischemic stroke patients.

      Methods

      A total of 3216 acute ischemic stroke patients from 22 hospitals were included in this analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Logistic regression model was performed to estimate the relationship between TyG index and unfavorable functional outcome of death or disability (modified Rankin Scale score of 4 to 6) at discharge. Risk reclassification with TyG index to predict unfavorable functional outcome was analyzed.

      Results

      During hospitalization, 748 patients (23.3%) experienced poor functional outcome and 105 patients (3.3%) died from all causes. The multivariable adjusted odds ratios for the highest versus lowest quartile of TyG index was 1.62 (95% CI 1.15-2.29) for unfavorable functional outcome at discharge. The addition of TyG index to the conventional model improved the risk reclassification (net reclassification improvement 10.37%; integrated discrimination improvement 0.27%; both p<0.05) for poor functional outcome. Moreover, TyG index was associated with an odds ratio (95% CI) of 1.26 (1.02-1.55) for an ordinal shift in mRS score and 2.49 (1.21-5.12) for in-hospital mortality.

      Conclusions

      Higher TyG index was associated with higher risk of unfavorable functional outcome at discharge and in-hospital mortality, implicating the significant short-term prognostic effect of TyG index in patients with ischemic stroke.

      Keywords

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