Triglyceride-glucose index is associated with early neurological deterioration in single subcortical infarction: Early prognosis in single subcortical infarctions

Background The research about the influence of triglyceride-glucose index on early prognosis in stroke is lacking. Aims In this study, we evaluated the association between triglyceride-glucose index and early neurological deterioration in patients with single subcortical infarctions. Methods Consecutive patients with single subcortical infarctions within 72 h of symptom onset between 2011 and 2015. Early neurological deterioration was defined as an increase of ≥2 in the total NIHSS score or ≥1 in the motor NIHSS score. The triglyceride-glucose index was calculated using the log scale of fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2. Results A total of 305 patients with single subcortical infarctions were evaluated. In multivariable analysis, the triglyceride-glucose index (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.58–5.45) and age (aOR = 1.05, 95% CI = 1.01–1.09) were associated with early neurological deterioration. In subgroup analysis according to the type of single subcortical infarctions, only patients with proximal single subcortical infarctions showed a significant association between the triglyceride-glucose index and early neurological deterioration (aOR = 2.92, 95% CI = 1.35–6.29). On the other hand, there was no statistical significance in patients with distal single subcortical infarctions. Patients with untreated diabetes also showed the close association between the triglyceride-glucose index and early neurological deterioration (aOR = 3.94, 95% CI = 1.47–10.52). Conclusions The triglyceride-glucose index was associated with early neurological deterioration in single subcortical infarctions. This association differed depending on the location of lesion and the presence of untreated diabetes.

[1]  Hao Li,et al.  Triglyceride Glucose Index and Prognosis of Patients With Ischemic Stroke , 2020, Frontiers in Neurology.

[2]  Han-Yeong Jeong,et al.  High triglyceride-glucose index is associated with subclinical cerebral small vessel disease in a healthy population: a cross-sectional study , 2020, Cardiovascular Diabetology.

[3]  J. Alizargar,et al.  Use of the triglyceride-glucose index (TyG) in cardiovascular disease patients , 2020, Cardiovascular Diabetology.

[4]  Shuang Liu,et al.  Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population. , 2019, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[5]  S. Khan,et al.  Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance , 2018, Diabetology & Metabolic Syndrome.

[6]  A. Haydon,et al.  High neutrophil‐to‐lymphocyte ratio predicts poor prognosis in patients with squamous cell carcinoma of the head and neck treated with definitive chemoradiotherapy , 2018, Asia-Pacific journal of clinical oncology.

[7]  Zaiwang Li,et al.  The initial glycemic variability is associated with early neurological deterioration in diabetic patients with acute ischemic stroke , 2018, Neurological Sciences.

[8]  J. Hata,et al.  Insulin resistance and clinical outcomes after acute ischemic stroke , 2018, Neurology.

[9]  Min Kyung Kim,et al.  Association between triglyceride glucose index and arterial stiffness in Korean adults , 2018, Cardiovascular Diabetology.

[10]  Min Kyung Kim,et al.  Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults , 2017, Cardiovascular Diabetology.

[11]  Jiangbin Liu,et al.  Effect of blood pressure variability on early neurological deterioration in single small subcortical infarction with parental arterial disease , 2017, eNeurologicalSci.

[12]  T. J. Kim,et al.  D‐dimer as a predictor of early neurologic deterioration in cryptogenic stroke with active cancer , 2017, European journal of neurology.

[13]  D. Agrawal,et al.  Pathogenesis of the Plaque Vulnerability in Diabetes Mellitus , 2017 .

[14]  B. Kim,et al.  Neuroimaging Markers for Early Neurologic Deterioration in Single Small Subcortical Infarction , 2015, Stroke.

[15]  Y. Xiong,et al.  Acute Diffusion-Weighted Imaging Lesion Patterns Predict Progressive Small Subcortical Infarct in the Perforator Territory of the Middle Cerebral Artery , 2015, International journal of stroke : official journal of the International Stroke Society.

[16]  Yilong Wang,et al.  Distal Single Subcortical Infarction Had a Better Clinical Outcome Compared With Proximal Single Subcortical Infarction , 2014, Stroke.

[17]  Yilong Wang,et al.  The infarct location predicts the outcome of single small subcortical infarction in the territory of the middle cerebral artery. , 2014, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[18]  B. Kim,et al.  Branching Patterns Determine the Size of Single Subcortical Infarctions , 2014, Stroke.

[19]  S. Nishimura,et al.  Insulin resistance is associated with coronary plaque vulnerability: insight from optical coherence tomography analysis. , 2014, European heart journal cardiovascular Imaging.

[20]  Youngshin Yoon,et al.  Single Subcortical Infarction Associated with Parental Arterial Disease: Important Yet Neglected Sub-Type of Atherothrombotic Stroke , 2013, International journal of stroke : official journal of the International Stroke Society.

[21]  Juan Feng,et al.  Heterogeneity of single small subcortical infarction can be reflected in lesion location , 2013, Neurological Sciences.

[22]  Jae-Sung Lim,et al.  Hypertriglyceridemia as a possible predictor of early neurological deterioration in acute lacunar stroke , 2011, Journal of the Neurological Sciences.

[23]  S. Martin-Schild,et al.  Early Neurological Deterioration (END) after Stroke: The END Depends on the Definition , 2011, International journal of stroke : official journal of the International Stroke Society.

[24]  S. Kwon,et al.  Diversity of Single Small Subcortical Infarctions According to Infarct Location and Parent Artery Disease: Analysis of Indicators for Small Vessel Disease and Atherosclerosis , 2010, Stroke.

[25]  M. Rodríguez-Moran,et al.  The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. , 2008, Metabolic syndrome and related disorders.

[26]  C. Chung,et al.  Prediction of Progressive Motor Deficits in Patients with Deep Subcortical Infarction , 2008, Cerebrovascular Diseases.

[27]  J. Wilhjelm,et al.  Echolucent, rupture-prone carotid plaques associated with elevated triglyceride-rich lipoproteins, particularly in women. , 2002, Journal of vascular surgery.

[28]  C. Viscoli,et al.  Insulin resistance and risk for stroke , 2002, Neurology.

[29]  J. Serena,et al.  Neurological Deterioration in Acute Lacunar Infarctions: The Role of Excitatory and Inhibitory Neurotransmitters , 2001, Stroke.