Zhongguo quanke yixue (Dec 2023)
Correlation of Triglyceride Glucose Index with Early Neurological Deterioration in Patients with Single Subcortical Infarction
Abstract
Background Early neurological deterioration (END) is common after acute ischemic stroke, which contributes to increased functional impairment and mortality in patients. Triglyceride glucose index (TyG index) is an independent predictor of the severity of neurological deficits in patients with acute ischemic stroke and is also associated with early recurrent ischemic lesions, however, its correlation with the incidence of END in single subcortical infarction (SSI) has been rarely reported and the correlation remains unclear. Objective To investigate the correlation between TyG index and the incidence of END in patients with SSI. Methods A total of 197 patients diagnosed with SSI and admitted within 72 h after symptom onset in the Department of Neurology, the Third Hospital of Hebei Medical University from 2020 to 2021 were included in the study and divided into the END group (n=45) and non-END group (n=152) based on whether END was developed. The clinical data of the patients were collected and multivariate Logistic regression analysis was used to investigate the correlation between TyG index and the incidence of END in patients with SSI. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of TyG index for END in patients with SSI. Results The proportion of patients with diabetes, FBG, TG and TyG index were higher in the END group than the non-END group (P<0.05). Multivariate Logistic regression showed that elevated TyG index was a risk factor for END in patients with SSI〔OR=1.726, 95%CI (1.008, 2.956), P=0.047〕. On different lesion infarct sites, elevated TyG index was a risk factor for END in SSI patients with basal ganglia as the infarction area〔OR=3.164, 95%CI (1.290, 7.760), P=0.012〕. Elevated TyG index was not associated with the occurrence of END in SSI patients with centrum semiovale as the infarction area (P>0.05). The ROC area under the curve (AUC) of TyG index for predicting END in patients with SSI was 0.66〔95%CI (0.57, 0.75), P=0.001〕, with an optimal cut-off value of 8.61, sensitivity of 0.689 and specificity of 0.638. Patients were divided into those with TyG index≥8.61 (n=86) and those with TyG index <8.61 (n=111) according to the optimal cut-off value of TyG index. Compared with those with TyG index<8.61, patients with TyG index≥8.61 had higher proportion of hyperlipidemia and diabetes, as well as higher levels of FBG, TC, TG, LDL and increased proportion of END, with lower age and HDL (P<0.05) . Conclusion TyG index is correlated with END in SSI patients, and increased TyG index is an independent risk factor for END in SSI patients, a high TyG index was significant in predicting the occurrence of END in patients with infarcts in the basal ganglia region, but not in patients with infarcts in the centrum semiovale.
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