OBJECTIVE

Fasting blood glucose (FBG) is a recognized risk factor for Ischemic Stroke, but little research has examined the interaction among FBG, Platelet Distribution Width (PDW) and the severity of neuronal damage. Thus, the present study constructs a moderated mediation model aimed to elucidate the relationships among FBG, PDW, and NIHSS scores in patients with acute ischemic stroke (AIS).

METHODS

We conducted a cross-sectional study on 431 AIS patients. Upon hospital admission, we assessed the patients' NIHSS scores and collected blood samples to measure FBG and PDW levels. The relationship between FBG and NIHSS scores moderated by PDW was analyzed by linear curve fitting analysis, multiple linear regression analysis, and moderated mediation analysis respectively.

RESULTS

In the tertile grouping based on FBG, both PDW and NIHSS scores of AIS patients demonstrated an increase corresponding with rising levels of FBG (<0.001 for both). Multiple linear regression analysis revealed that, the coefficients (95% CI) for the relationship between FBG and NIHSS scores were 1.49 (1.27-1.71, <0.01) post-adjustment for potential confounders. The coefficients (95% CI) for the relationship between FBG and PDW were 0.02 (0.01-0.04, <0.01) post-adjustment. Likewise, for the relationship between PDW and NIHSS scores, the coefficients (95% CI) were 4.33 (3.07-5.59, <0.01) after adjustment. These positive association remained consistent in sensitivity analysis and hierarchical analysis. Smoothed plots suggested that there are linear relationships between FBG and PDW and NIHSS scores respectively. Further mediation analysis indicated that increased PDW significantly (<0.01) mediated 5.91% of FBG-associated increased NIHSS scores.

CONCLUSION

This study suggested that FBG levels were associated with NIHSS scores, and the FBG-associated neurological impairment may be partially mediated by PDW. These findings underscore the importance of monitoring FBG and PDW levels in AIS patients, potentially guiding risk intervention strategies.