{"title":"动脉瘤性蛛网膜下腔出血患者甘油三酯-葡萄糖指数与功能结局的关系：一项回顾性队列研究","authors":"Yuyang Hou, Xinyi Guo, Hongkuan Yang, Hua Li, Rudong Chen, Xiaoli Min, Jiasheng Yu","doi":"10.1186/s40001-025-02629-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening disease with high morbidity and mortality. The triglyceride-glucose (TyG) index, a marker of insulin resistance (IR), has been linked to adverse outcomes in cerebrovascular conditions; however, its influence on functional prognosis in aSAH remains unclear. This study aimed to elucidate the relationship between the TyG index and functional outcomes in aSAH patients.</p><p><strong>Methods: </strong>A retrospective cohort study included consecutive aSAH patients. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and categorized as favorable (mRS 0-2) or unfavorable (mRS 3-6). Univariate and multivariate logistic regression analyzed the association between the TyG index and functional outcomes. Propensity score matching (PSM) was used to mitigate confounding. Non-linear relationships were explored with restricted cubic splines (RCS), and subgroup analyses were performed. A nomogram integrating the TyG index and traditional prognostic scales was developed, and model predictive performance was compared using the area under the curve (AUC) on a test set.</p><p><strong>Results: </strong>A total of 470 patients (61.7% female) were enrolled, with 154 experiencing unfavorable outcomes. Multivariate logistic regression showed a significant association between the TyG index and adverse outcomes (OR: 1.86, 95% CI 1.12-3.1, P = 0.017). An optimal TyG index cutoff of 8.83 was identified. Patients with TyG index ≥ 8.83 had a higher risk of poor outcomes (48.7% vs. 24.8%; P = 0.015). PSM confirmed these findings. RCS indicated a progressive association between elevated TyG index and increased risk of adverse functional outcome. Subgroup analyses showed consistent relationships. The enhanced model with the TyG index had a higher AUC (0.899) than the traditional model (0.889, DeLong test P = 0.048).</p><p><strong>Conclusions: </strong>A high TyG index is significantly associated with an increased risk of unfavorable functional outcomes in patients with aSAH.</p>","PeriodicalId":11949,"journal":{"name":"European Journal of Medical Research","volume":"30 1","pages":"375"},"PeriodicalIF":2.8000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063392/pdf/","citationCount":"0","resultStr":"{\"title\":\"The relationship between the triglyceride-glucose index and functional outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective cohort study.\",\"authors\":\"Yuyang Hou, Xinyi Guo, Hongkuan Yang, Hua Li, Rudong Chen, Xiaoli Min, Jiasheng Yu\",\"doi\":\"10.1186/s40001-025-02629-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening disease with high morbidity and mortality. The triglyceride-glucose (TyG) index, a marker of insulin resistance (IR), has been linked to adverse outcomes in cerebrovascular conditions; however, its influence on functional prognosis in aSAH remains unclear. This study aimed to elucidate the relationship between the TyG index and functional outcomes in aSAH patients.</p><p><strong>Methods: </strong>A retrospective cohort study included consecutive aSAH patients. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and categorized as favorable (mRS 0-2) or unfavorable (mRS 3-6). Univariate and multivariate logistic regression analyzed the association between the TyG index and functional outcomes. Propensity score matching (PSM) was used to mitigate confounding. Non-linear relationships were explored with restricted cubic splines (RCS), and subgroup analyses were performed. A nomogram integrating the TyG index and traditional prognostic scales was developed, and model predictive performance was compared using the area under the curve (AUC) on a test set.</p><p><strong>Results: </strong>A total of 470 patients (61.7% female) were enrolled, with 154 experiencing unfavorable outcomes. Multivariate logistic regression showed a significant association between the TyG index and adverse outcomes (OR: 1.86, 95% CI 1.12-3.1, P = 0.017). An optimal TyG index cutoff of 8.83 was identified. Patients with TyG index ≥ 8.83 had a higher risk of poor outcomes (48.7% vs. 24.8%; P = 0.015). PSM confirmed these findings. RCS indicated a progressive association between elevated TyG index and increased risk of adverse functional outcome. Subgroup analyses showed consistent relationships. The enhanced model with the TyG index had a higher AUC (0.899) than the traditional model (0.889, DeLong test P = 0.048).</p><p><strong>Conclusions: </strong>A high TyG index is significantly associated with an increased risk of unfavorable functional outcomes in patients with aSAH.</p>\",\"PeriodicalId\":11949,\"journal\":{\"name\":\"European Journal of Medical Research\",\"volume\":\"30 1\",\"pages\":\"375\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063392/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Medical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40001-025-02629-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Medical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40001-025-02629-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：动脉瘤性蛛网膜下腔出血（aSAH）是一种发病率和死亡率高、危及生命的疾病。甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗（IR）的标志，与脑血管疾病的不良结局有关；然而，其对aSAH患者功能预后的影响尚不清楚。本研究旨在阐明TyG指数与aSAH患者功能结局之间的关系。方法：回顾性队列研究纳入连续aSAH患者。在3个月时使用改良的Rankin量表（mRS）评估功能结果，并将其分为有利（mRS 0-2）和不利（mRS 3-6）。单因素和多因素logistic回归分析了TyG指数与功能结局之间的关系。倾向评分匹配（PSM）用于减轻混淆。用限制三次样条（RCS）探讨非线性关系，并进行亚组分析。建立了TyG指数与传统预测量表相结合的nomogram，并利用测试集的曲线下面积（area under the curve， AUC）对模型的预测性能进行了比较。结果：共纳入470例患者（61.7%为女性），其中154例出现不良结局。多因素logistic回归显示TyG指数与不良结局之间存在显著相关性（OR: 1.86, 95% CI 1.12-3.1, P = 0.017）。优选的TyG指数截止值为8.83。TyG指数≥8.83的患者预后不良的风险较高(48.7% vs. 24.8%；p = 0.015)。PSM证实了这些发现。RCS显示TyG指数升高与不良功能结局风险增加之间存在渐进式关联。亚组分析显示了一致的关系。TyG指数增强模型的AUC（0.899）高于传统模型（0.889，DeLong检验P = 0.048）。结论：高TyG指数与aSAH患者不良功能结局的风险增加显著相关。
The relationship between the triglyceride-glucose index and functional outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective cohort study.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening disease with high morbidity and mortality. The triglyceride-glucose (TyG) index, a marker of insulin resistance (IR), has been linked to adverse outcomes in cerebrovascular conditions; however, its influence on functional prognosis in aSAH remains unclear. This study aimed to elucidate the relationship between the TyG index and functional outcomes in aSAH patients.
Methods: A retrospective cohort study included consecutive aSAH patients. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and categorized as favorable (mRS 0-2) or unfavorable (mRS 3-6). Univariate and multivariate logistic regression analyzed the association between the TyG index and functional outcomes. Propensity score matching (PSM) was used to mitigate confounding. Non-linear relationships were explored with restricted cubic splines (RCS), and subgroup analyses were performed. A nomogram integrating the TyG index and traditional prognostic scales was developed, and model predictive performance was compared using the area under the curve (AUC) on a test set.
Results: A total of 470 patients (61.7% female) were enrolled, with 154 experiencing unfavorable outcomes. Multivariate logistic regression showed a significant association between the TyG index and adverse outcomes (OR: 1.86, 95% CI 1.12-3.1, P = 0.017). An optimal TyG index cutoff of 8.83 was identified. Patients with TyG index ≥ 8.83 had a higher risk of poor outcomes (48.7% vs. 24.8%; P = 0.015). PSM confirmed these findings. RCS indicated a progressive association between elevated TyG index and increased risk of adverse functional outcome. Subgroup analyses showed consistent relationships. The enhanced model with the TyG index had a higher AUC (0.899) than the traditional model (0.889, DeLong test P = 0.048).
Conclusions: A high TyG index is significantly associated with an increased risk of unfavorable functional outcomes in patients with aSAH.
期刊介绍：
European Journal of Medical Research publishes translational and clinical research of international interest across all medical disciplines, enabling clinicians and other researchers to learn about developments and innovations within these disciplines and across the boundaries between disciplines. The journal publishes high quality research and reviews and aims to ensure that the results of all well-conducted research are published, regardless of their outcome.
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