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.
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.
Nutr Metab Cardiovasc Dis. 2023 Feb;33(2):399-407. doi: 10.1016/j.numecd.2022.11.004. Epub 2022 Nov 8.
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.
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 4-6) at discharge. Risk reclassification with TyG index to predict unfavorable functional outcome was analyzed. 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.
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.
甘油三酯-葡萄糖(TyG)指数已被证明是缺血性卒中的独立标志物。TyG 指数是否能预测缺血性卒中患者的短期预后尚不确定。本研究旨在探讨 TyG 指数在缺血性卒中患者中的早期预后价值。
共纳入 22 家医院的 3216 例急性缺血性卒中患者。TyG 指数的计算方法为 ln(空腹甘油三酯[mg/dL]×空腹血糖[mg/dL]/2)。采用 logistic 回归模型评估 TyG 指数与出院时不良功能结局(改良 Rankin 量表评分 4-6)之间的关系。分析 TyG 指数对不良功能结局的风险再分类。住院期间,748 例(23.3%)患者预后不良,105 例(3.3%)患者因各种原因死亡。最高四分位与最低四分位 TyG 指数相比,出院时不良功能结局的多变量校正比值比为 1.62(95%CI 1.15-2.29)。将 TyG 指数加入常规模型可改善风险再分类(净再分类改善 10.37%;综合判别改善 0.27%;均 P<0.05)。此外,TyG 指数与不良功能结局的优势比(95%CI)为 1.26(1.02-1.55),与 mRS 评分的有序变化相关,与住院期间死亡率的优势比(95%CI)为 2.49(1.21-5.12)。
较高的 TyG 指数与出院时不良功能结局和住院期间死亡率的风险增加相关,提示 TyG 指数对缺血性卒中患者具有重要的短期预后意义。