Association of the admission triglyceride-glucose (TyG) index with etiologic subtype, infarct localization, clinical severity, and functional status in ischemic stroke patients
Year: 2026
Type: article
Abstract: Introduction: The triglyceride-glucose (TyG) index is an indirect marker of insulin resistance. Because the index is calculated from triglyceride and glucose values, it is important to separate the contribution of diabetes mellitus (DM) to its reported associations in ischemic stroke. We investigated the association of the admission TyG index with etiology (TOAST), infarct localization (Bamford), clinical severity, and functional status.Methods: Thirty-two consecutive patients with acute ischemic stroke were reviewed retrospectively. The TyG index was calculated as ln[triglycerides×glucose/2]. Severity was assessed with the National Institutes of Health Stroke Scale (NIHSS) and functional status with the discharge modified Rankin Scale (mRS; 0–2 good, 3–6 poor). The Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation, stratified analysis, logistic regression, and ROC analysis were applied.Results: Mean age was 68.4±12.7 years, 62.5% were men, mean TyG was 9.15±0.82, and 43.8% had DM. No association was found between TyG and admission NIHSS (rho=-0.084; p=0.649) or Bamford subtypes (p=0.782). TyG was similar in the good (n=25) and poor (n=7) outcome groups (9.22±0.89 and 8.90±0.45; p=0.294); the area under the curve was 0.366. Poor outcome was associated with age (p=0.016) and NIHSS (p=0.001). TyG was higher in small vessel disease (9.52±0.94 vs 8.83±0.55; p=0.007). However, TyG was markedly higher in patients with DM (9.70 vs 8.73; p=0.002), and DM was twice as frequent in this group (60.0% vs 29.4%). After adjustment for DM, the association lost significance (OR 3.13; 95% CI 0.85–11.63; p=0.088); it was also nonsignificant in the stratified analysis (p=0.112 and 0.291). TyG was determined predominantly by triglycerides (rho=+0.944) and correlated with HbA1c (rho=+0.538; p=0.002). On cervical vascular ultrasonography, no stenosis or occlusion was found in 71.9% of the patients; stenosis of 50% or more was present in only 5 patients (Table).Discussion/Conclusion: The admission TyG index was not associated with stroke severity, infarct localization, or short-term functional status. In contrast, the TyG index was significantly higher in patients with DM and was determined predominantly by triglyceride level; the crude association observed with small vessel etiology also disappeared after adjustment for DM. These findings suggest that, in this series, TyG reflects glycemic and lipid status rather than acting as an independent marker. The variables determining short-term prognosis were advanced age and a high admission NIHSS score. The low atherosclerotic burden of the cohort, the sample size, and the small number of poor-outcome events are the main limitations.Keywords:
Authors: Nazlı Gündoğan Demirci, Gülcan Taşçatan
Institution: Zonguldak Bülent Ecevit University
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225830472
FWCI:
Cites:
Cited by:
Related to: