Association of higher triglyceride-glucose index and triglyceride-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke patients

Mingzhu Deng; Kangping Song; Wei Xu; Guohua He; Jue Hu; Hui Xiao; Nina Zhou; Sufen Chen; Guilan Xu; Yangping Tong; Dan Zhang; Zhen Wang; Fangyi Li

doi:10.3389/fneur.2024.1421655

Association of higher triglyceride-glucose index and triglyceride-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke patients

Front Neurol. 2024 Aug 21:15:1421655. doi: 10.3389/fneur.2024.1421655. eCollection 2024.

Authors

Mingzhu Deng^#¹, Kangping Song^#², Wei Xu^#², Guohua He², Jue Hu², Hui Xiao², Nina Zhou¹, Sufen Chen², Guilan Xu², Yangping Tong², Dan Zhang², Zhen Wang², Fangyi Li²

Affiliations

¹ Department of Neurology, Brain Hospital of Hunan Province, The Second People's Hospital of Hunan Province, Changsha, China.
² Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.

^# Contributed equally.

Abstract

Background: Insulin resistance (IR) can predict the prognosis of patients suffering from cerebrovascular disorders. The triglyceride-glucose (TyG) index and triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio have been confirmed to be easy and reliable indicators of IR. However, the relationships between the TyG index or TG/HDL-C ratio and early neurological deterioration (END) after thrombolysis in patients with acute ischemic stroke (AIS) are uncertain.

Methods: A retrospective analysis of 1,187 patients diagnosed with AIS who underwent intravenous thrombolysis between January 2018 and February 2024 was performed. Post-thrombolysis END was defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) score of ≥4 within 24 h after thrombolysis. Logistic regression analysis was performed to explore the relationships of the TyG index and TG/HDL-C ratio with post-thrombolysis END. Receiver operating characteristic (ROC) analysis was used to assess the ability of the TyG index and TG/HDL-C ratio to discriminate post-thrombolysis END.

Results: Among the 1,187 recruited patients, 179 (15.08%) were diagnosed with post-thrombolysis END, and 1,008 (84.92%) were diagnosed with non-END. A binary logistic regression model indicated that the TyG index (odds ratio [OR], 2.015; 95% confidence interval [CI] 1.964-2.414, p = 0.015) and TG/HDL-C ratio (OR, 1.542; 95% CI, 1.160-2.049, p = 0.004) were independent factors for post-thrombolysis END. The area under the curve (AUC) values for the TyG index, TG/HDL-C ratio, and TyG index combined with the TG/HDL-C ratio for post-thrombolysis END were 0.704, 0.674, and 0.755, respectively.

Conclusion: This study indicates that the TyG index and TG/HDL-C ratio can be used as prognostic factors to predict post-thrombolysis END.

Keywords: acute ischemic stroke; early neurological deterioration; intravenous thrombolysis; triglyceride-to-high-density lipoprotein cholesterol ratio; triglyceride–glucose index.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Natural Science Foundation of Hunan Province (grant no. 2023JJ40072), the Science and Technology Planning Project of Hunan Health Committee (grant no. D202303076376), the Medical Clinical Research 4310 Project of University of South China (grant no. KJZX2021078), the Scientific Research Project of Hunan Provincial Health Commission (No. 202103070273), the Changsha Science and Technology Project (No. kzd2001068), and the Funded Project of the Affiliated Changsha Central Hospital, University of South China (No. YNKY202211).