Wang Shengyuan, Ning Xianjia, Tu Jun, Wang Jinghua, Zhao Yu
Department of Neurology, Chongqing General Hospital, Chongqing University, Chongqing, China.
Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
Front Endocrinol (Lausanne). 2025 May 22;16:1523787. doi: 10.3389/fendo.2025.1523787. eCollection 2025.
Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality, and identifying reliable prognostic markers is crucial for improving outcomes. The triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, has been associated with adverse cardiovascular outcomes. However, its role in predicting stroke prognosis, particularly in non-diabetic patients, remains unclear. This study aimed to explore the association between the TyG index and one-year outcomes, including mortality, recurrence, and adverse functional outcomes, in non-diabetic IS patients.
This prospective cohort study included AIS patients without diabetes from multiple hospitals. Baseline data, including the TyG index, were collected at admission, and patients were followed for one year. The primary outcomes were all-cause mortality, stroke recurrence, and adverse functional outcomes, defined as modified Rankin Scale (mRS) >2. Multivariate logistic regression and subgroup analyses were conducted to assess the predictive value of the TyG index for these outcomes.
Among the study population, 5.9% died within one year. The TyG index and its quartiles were significantly associated with one-year mortality, even after adjusting for confounding factors. Patients in the highest TyG quartile (Q4: TyG ≥ 8.9002) had a 3.72-fold higher risk of mortality compared to those in the lowest quartile (P = 0.013). Subgroup analysis showed that the TyG index was a stronger predictor of mortality in men and non-atrial fibrillation patients. Although the TyG index was not significantly associated with stroke recurrence or adverse functional outcomes in the overall cohort, it acted as a protective factor for recurrence in younger patients (< 65 years).
The TyG index is an independent predictor of one-year mortality in non-diabetic IS patients and may aid in risk stratification, particularly in men and younger patients. Its potential role in predicting recurrence and functional outcomes warrants further investigation.
急性缺血性卒中（AIS）是发病和死亡的主要原因，识别可靠的预后标志物对于改善预后至关重要。甘油三酯-葡萄糖（TyG）指数作为胰岛素抵抗的替代标志物，与不良心血管结局相关。然而，其在预测卒中预后，尤其是非糖尿病患者中的作用仍不清楚。本研究旨在探讨非糖尿病缺血性卒中（IS）患者中TyG指数与包括死亡率、复发率和不良功能结局在内的一年期结局之间的关联。
这项前瞻性队列研究纳入了多家医院的非糖尿病AIS患者。入院时收集包括TyG指数在内的基线数据，并对患者进行一年随访。主要结局为全因死亡率、卒中复发率和不良功能结局，不良功能结局定义为改良Rankin量表（mRS）评分>2。进行多因素逻辑回归和亚组分析以评估TyG指数对这些结局的预测价值。
在研究人群中，5.9%的患者在一年内死亡。即使在调整混杂因素后，TyG指数及其四分位数与一年期死亡率仍显著相关。TyG四分位数最高的患者（Q4：TyG≥8.9002）的死亡风险是四分位数最低患者的3.72倍（P = 0.013）。亚组分析表明，TyG指数在男性和非房颤患者中是更强的死亡率预测指标。尽管在整个队列中TyG指数与卒中复发或不良功能结局无显著关联，但在年轻患者（<65岁）中它是复发的保护因素。
TyG指数是非糖尿病IS患者一年期死亡率的独立预测指标，可能有助于风险分层，尤其是在男性和年轻患者中。其在预测复发和功能结局方面的潜在作用值得进一步研究。
