Zhang Dong, Ma Ruinan, Qin Xiaoyan, Li Zhizhang, Zhang Xiaoguang, Ding Ying, Hu Yunqi, Yue Yunhua
Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Geriatrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Neurol. 2025 Jun 5;16:1581747. doi: 10.3389/fneur.2025.1581747. eCollection 2025.
The glucose-to-potassium ratio has shown promise as a biomarker in neurological disorders, but its prognostic value in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) continues to be uncertain. The study explores the relationship between admission GPR and 90-day functional outcomes in AIS patients undergoing IVT treatment.
A retrospective analysis included 649 AIS patients undergoing IVT between May 2016 and December 2023. Baseline clinical, laboratory, and imaging data were analyzed. GPR was calculated from serum glucose and potassium levels at admission. A modified Rankin Scale score of 3 to 6 at 90 days was used to define poor functional outcomes. Logistic regression and restricted cubic splines assessed the GPR-outcome relationship, adjusting for confounders. Receiver operating characteristic (ROC) analysis evaluated GPR's predictive value.
Among 649 patients, 174 (26.8%) had poor outcomes. Median GPR was significantly higher in these patients (2.14 vs. 1.88, < 0.001). Higher GPR independently predicted negative consequences (OR, 1.821; 95% CI, 1.340-2.473, < 0.001). Subgroup analysis indicated a stronger association in non-diabetic patients. ROC analysis demonstrated an area under the curve (AUC) of 0.631 (95% CI, 0.585-0.677, < 0.001) for GPR in predicting poor functional outcomes.
High GPR levels are independently linked to unfavorable 90-day functional outcomes in AIS patients who received IVT, suggesting its potential as a prognostic biomarker. Further studies are warranted to validate these findings.
葡萄糖与钾的比值已显示出作为神经疾病生物标志物的潜力，但其在急性缺血性卒中（AIS）静脉溶栓（IVT）后的预后价值仍不确定。本研究探讨接受IVT治疗的AIS患者入院时的葡萄糖与钾比值（GPR）与90天功能结局之间的关系。
一项回顾性分析纳入了2016年5月至2023年12月期间接受IVT的649例AIS患者。分析了基线临床、实验室和影像学数据。根据入院时的血清葡萄糖和钾水平计算GPR。使用90天时改良Rankin量表评分为3至6来定义功能结局不良。逻辑回归和受限立方样条评估了GPR与结局之间的关系，并对混杂因素进行了调整。受试者工作特征（ROC）分析评估了GPR的预测价值。
在649例患者中，174例（26.8%）结局不良。这些患者的GPR中位数显著更高（2.14对1.88，<0.001）。较高的GPR独立预测不良后果（OR，1.821；95%CI，1.340 - 2.473，<0.001）。亚组分析表明在非糖尿病患者中关联更强。ROC分析显示GPR预测功能结局不良的曲线下面积（AUC）为0.631（95%CI，0.585 - 0.677，<0.001）。
高GPR水平与接受IVT的AIS患者90天功能结局不良独立相关，表明其作为预后生物标志物的潜力。有必要进行进一步研究以验证这些发现。
