# Triglyceride–Glucose Index and Short‐Term Functional Prognosis in Patients With Acute Ischemic Stroke: A Retrospective Study

## TL;DR

A high triglyceride–glucose index is linked to worse recovery after stroke, and combining it with a stroke severity score improves prediction accuracy.

## Contribution

This study identifies the TyG index as an independent predictor of poor stroke recovery and shows that combining it with NIHSS improves prediction accuracy.

## Key findings

- The TyG index is an independent risk factor for poor 3-month functional outcomes in AIS patients.
- The TyG-NIHSS model has higher predictive accuracy (AUC 0.836) than the TyG index alone (AUC 0.650).
- TyG-NIHSS has 80.6% sensitivity and 76.7% specificity for predicting poor outcomes.

## Abstract

Stroke is the most significant cause of death and disability around the world. It is the second leading cause of death after cardiovascular disease. Currently, the triglyceride–glucose (TyG) index has proven to be a reliable surrogate indicator of IR in stroke studies. However, the relationship between TyG and poor functional outcomes in patients with ischemic stroke remains unclear. Accordingly, this study aimed to explore the relationship between TyG index and clinical outcomes at 3 months after acute ischemic stroke (AIS).

The clinical data of 564 AIS patients admitted to the Second People's Hospital of Hefei from January 2020 to September 2024 were collected. According to the mRS score at 3 months after onset, the patients were divided into a poor functional prognosis group and a good functional prognosis group. Univariate and multivariate logistic regression models were used to explore the correlation between the TyG index at admission and the 3‐month functional prognosis of AIS patients. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the TyG index and the TyG index combined with the admission NIHSS score (TyG‐NIHSS) for the 3‐month functional prognosis of AIS patients.

A total of 564 AIS patients were included, with 165 cases (29.25%) in the poor functional prognosis group and 399 cases (70.75%) in the good functional prognosis group. Multivariate logistic regression analysis showed that systolic blood pressure at admission, NIHSS score, and TyG index were independent risk factors for poor functional prognosis at 3 months in AIS patients (p < 0.05). The higher the TyG index, the higher the risk of poor functional prognosis at 3 months (OR = 3.18, 95% CI: 2.252–4.499, p < 0.001). ROC curve analysis showed that the area under the curve (AUC) for the TyG index to predict poor functional prognosis at 3 months in AIS patients was 0.650 (95% CI: 0.598–0.702, p < 0.001), with a sensitivity of 61.2% and a specificity of 62.7%. The AUC for TyG‐NIHSS to predict poor functional prognosis at 3 months in AIS patients was 0.836 (95% CI: 0.799–0.873, p < 0.001), with a sensitivity of 80.6% and a specificity of 76.7%.

The TyG index is an independent but moderate predictor of poor outcomes at 3 months poststroke. However, TyG‐NIHSS represents a highly discriminative multivariate model. This model demonstrates good predictive ability and high predictive accuracy.

A high triglyceride–glucose (TyG) index is an independent risk factor for poor functional outcome at 3 months in patients with acute ischemic stroke (AIS). The predictive accuracy of the combined TyG‐NIHSS model for a poor 3‐month outcome was significantly higher than that of the TyG index alone
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