What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute ischemic stroke (n=176). Intervention: Triglyceride-glucose (TyG) index vs. Lower TyG index. Primary outcome: Early recurrent ischemic lesions (ERILs) (aOR 2.63, 95% CI 1.34-5.15, p=0.005).

July 28, 2021Scientific Reports86 citationsOpen Access

High triglyceride-glucose index is associated with early recurrent ischemic lesion in acute ischemic stroke

KNKi‐Woong NamSeoul National University HKHyung‐Min KwonSeoul National University YLYong-Seok LeeNew Generation University College

Key Result

A higher triglyceride-glucose index was significantly associated with early recurrent ischemic lesions in patients with acute ischemic stroke (aOR 2.63).

Study Design

Type

Cross-Sectional (n=176)

Multicenter

Structured PICO

Is a high triglyceride-glucose index associated with early recurrent ischemic lesions in patients with acute ischemic stroke?

Population

176 patients (mean age 71, 41.5% female) with acute ischemic stroke who underwent follow-up MRI within 7 days of admission, excluding those on prior glucose- or lipid-lowering agents.

Exposure

High triglyceride-glucose (TyG) index (calculated as log scale of fasting triglyceride × fasting glucose/2)

Outcome

Early recurrent ischemic lesions (ERILs), defined as new diffusion-weighted imaging lesions outside the initial symptomatic lesion areasurrogate

A higher triglyceride-glucose index is significantly associated with early recurrent ischemic lesions in patients with acute ischemic stroke, particularly in those with large artery atherosclerosis.

Main Result

Odds Ratio: 2.63 (95% CI 1.34–5.15)

p-value: p=0.005

Limitations

Retrospective cross-sectional design cannot prove a causal relationship
Selection bias due to the exclusion of patients who previously used glucose- and lipid-lowering agents
Follow-up MRI was often taken when clinical worsening occurred, leading to a higher frequency of 7-day clinical worsening in the study population
The effect of post-stroke hyperglycemia was not fully accounted for

Abstract

The triglyceride-glucose (TyG) index has been associated with various metabolic, cardiovascular, and cerebrovascular diseases. We evaluated the association between the TyG index and early recurrent ischemic lesions (ERILs) in patients with acute ischemic stroke (AIS). We included consecutive patients diagnosed with AIS between 2010 and 2016. ERILs were defined as new diffusion-weighted imaging lesions outside the initial symptomatic lesion area. The TyG index was calculated using the following formula: log scale of fasting triglyceride × fasting glucose/2. A total of 176 patients with AIS were evaluated. In the multivariable analysis, the TyG index remained significant (adjusted odds ratio aOR 2.63, 95% confidence interval CI 1.34-5.15). This close correlation between the TyG index and ERIL was pronounced in ERIL-same group (aOR 2.84, 95% CI 1.40-5.78), but not in ERIL-different group. When comparing the relationship between the TyG index and ERIL by stroke mechanisms, only the intracranial- and extracranial-large artery atherosclerosis groups showed significantly higher TyG index values in patients with ERIL than those without. In conclusion, a higher TyG index was associated with ERIL, especially ERIL-same, in patients with AIS. The TyG index appears to be involved in ERIL occurrence by a mechanism related to atherosclerosis.

问 AI

Bookmark

View Full Paper