Prognostic value of triglyceride-glucose index combined with stress hyperglycemia ratio for all-cause mortality in critically ill patients with stroke | Cardiovascular Diabetology

  • Chen Y, Yang Z, Liu Y, Li Y, Zhong Z, McDowell G, et al. Exploring the prognostic impact of triglyceride-glucose index in critically ill patients with first-ever stroke: insights from traditional methods and machine learning-based mortality prediction. Cardiovasc Diabetol. 2024;23(1):443.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Feigin VL, Abate MD, Abate YH, Abd ElHafeez S, Abd-Allah F, Abdelalim A, et al. Global, regional, and National burden of stroke and its risk factors, 1990–2021: a systematic analysis for the global burden of disease study 2021. Lancet Neurol. 2024;23(10):973–1003.

    Google Scholar 

  • Lavados PM, Hoffmeister L, Moraga AM, Vejar A, Vidal C, Gajardo C, et al. Incidence, risk factors, prognosis, and health-related quality of life after stroke in a low-resource community in Chile (ÑANDU): a prospective population-based study. Lancet Glob Health. 2021;9(3):e340–51.

    PubMed 

    Google Scholar 

  • Jin M, Bao Z, Hong X, He S, Gao F. The prognostic value of the stress hyperglycemia ratio for all-cause mortality in stroke patients with diabetes or prediabetes. J Diabetes Complicat. 2025;39(4):108979.

    Google Scholar 

  • Pu Y, Xing N, Wang Y, Wang H, Xu J, Li X. Differential impact of TyG and TyG-BMI indices on short- and long-term mortality in critically ill ischemic stroke patients. BMC Cardiovasc Disord. 2024;24(1):754.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Hoshino T, Mizuno T, Ishizuka K, Takahashi S, Arai S, Toi S, et al. Triglyceride-glucose index as a prognostic marker after ischemic stroke or transient ischemic attack: a prospective observational study. Cardiovasc Diabetol. 2022;21(1):264.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Wu L, Zhu J, Li C, Zhu J, Dai Z, Jiang Y. Association of triglyceride-glucose index with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion: a multicenter hospital-based prospective cohort study. Cardiovasc Diabetol. 2022;21(1):250.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Yang X, Wang G, Jing J, Wang A, Zhang X, Jia Q, et al. Association of triglyceride-glucose index and stroke recurrence among nondiabetic patients with acute ischemic stroke. BMC Neurol. 2022;22(1):79.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Li H, Tang T, Xiong L, Yin Y, Dai B. Interaction of Triglyceride-Glucose index and metabolic syndrome with risk of incident stroke among Middle-Aged and older Chinese adults. J Multidiscip Healthc. 2025;18:947–55.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Cai W, Xu J, Wu X, Chen Z, Zeng L, Song X, et al. Association between triglyceride-glucose index and all-cause mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database. Cardiovasc Diabetol. 2023;22(1):138.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Wang B, Li L, Tang Y, Ran X. Joint association of triglyceride glucose index (TyG) and body roundness index (BRI) with stroke incidence: a National cohort study. Cardiovasc Diabetol. 2025;24(1):164.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Ding L, Zhang H, Dai C, Zhang A, Yu F, Mi L, et al. The prognostic value of the stress hyperglycemia ratio for all-cause and cardiovascular mortality in patients with diabetes or prediabetes: insights from NHANES 2005–2018. Cardiovasc Diabetol. 2024;23(1):84.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zuo Z, Zhou Z, Liu Q, Shi R, Wu T. Joint association of the triglyceride-glucose index and stress hyperglycemia ratio with incidence and mortality risks of new-onset atrial fibrillation during sepsis: a retrospective cohort study. Cardiovasc Diabetol. 2025;24(1):149.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Dai Z, Cao H, Wang F, Li L, Guo H, Zhang X, et al. Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke. Front Endocrinol (Lausanne). 2023;14:1094353.

    PubMed 

    Google Scholar 

  • Peng Z, Song J, Li L, Guo C, Yang J, Kong W, et al. Association between stress hyperglycemia and outcomes in patients with acute ischemic stroke due to large vessel occlusion. CNS Neurosci Ther. 2023;29(8):2162–70.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Yuan C, Chen S, Ruan Y, Liu Y, Cheng H, Zeng Y, et al. The stress hyperglycemia ratio is associated with hemorrhagic transformation in patients with acute ischemic stroke. Clin Interv Aging. 2021;16:431–42.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Song Y, Cui K, Yang M, Song C, Yin D, Dong Q, et al. High triglyceride-glucose index and stress hyperglycemia ratio as predictors of adverse cardiac events in patients with coronary chronic total occlusion: a large-scale prospective cohort study. Cardiovasc Diabetol. 2023;22(1):180.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Liu C, Liang D, Xiao K, Xie L. Association between the triglyceride-glucose index and all-cause and CVD mortality in the young population with diabetes. Cardiovasc Diabetol. 2024;23(1):171.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Yang Y, Huang X, Wang Y, Leng L, Xu J, Feng L, et al. The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis. Cardiovasc Diabetol. 2023;22(1):2.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Cui K, Fu R, Yang J, Xu H, Yin D, Song W, et al. The impact of fasting stress hyperglycemia ratio, fasting plasma glucose and hemoglobin A1c on in-hospital mortality in patients with and without diabetes: findings from the China acute myocardial infarction registry. Cardiovasc Diabetol. 2023;22(1):165.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Hu B, Yang Z, Yuan L, Huang S, Huang X, Wang C, et al. Assessing the stress hyperglycemia ratio in hyperlipidemia patients to predict all-cause mortality: a retrospective cohort study. Diabetes Res Clin Pract. 2025;226:112301.

    PubMed 

    Google Scholar 

  • Carencotte R, Oliver M, Allou N, Ferdynus C, Allyn J. Exploring clinical practices of critical alarm settings in intensive care units: a retrospective study of 60,000 patient stays from the MIMIC-IV database. J Med Syst. 2024;48(1):88.

    PubMed 

    Google Scholar 

  • Tao LC, Xu JN, Wang TT, Hua F, Li JJ. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Cardiovasc Diabetol. 2022;21(1):68.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zhang Y, Yin X, Liu T, Ji W, Wang G. Association between the stress hyperglycemia ratio and mortality in patients with acute ischemic stroke. Sci Rep. 2024;14(1):20962.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Cheng S, Shen H, Han Y, Han S, Lu Y. Association between stress hyperglycemia ratio index and all-cause mortality in critically ill patients with atrial fibrillation: a retrospective study using the MIMIC-IV database. Cardiovasc Diabetol. 2024;23(1):363.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Cui C, Liu L, Qi Y, Han N, Xu H, Wang Z, et al. Joint association of TyG index and high sensitivity C-reactive protein with cardiovascular disease: a National cohort study. Cardiovasc Diabetol. 2024;23(1):156.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Cui C, Liu L, Zhang T, Fang L, Mo Z, Qi Y, et al. Triglyceride-glucose index, renal function and cardiovascular disease: a National cohort study. Cardiovasc Diabetol. 2023;22(1):325.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zhang R, Hong J, Wu Y, Lin L, Chen S, Xiao Y. Joint association of triglyceride glucose index (TyG) and a body shape index (ABSI) with stroke incidence: a nationwide prospective cohort study. Cardiovasc Diabetol. 2025;24(1):7.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Wu Z, Jiang Y, Li P, Wang Y, Zhang H, Li Z, et al. Association of impaired sensitivity to thyroid hormones with hyperuricemia through obesity in the euthyroid population. J Transl Med. 2023;21(1):436.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Hao B, Lyu L, Xu J, Zhu X, Xu C, Gao W, et al. The relationship between triglyceride-glucose index and prospective key clinical outcomes in patients hospitalised for coronary artery disease. Cardiovasc Diabetol. 2024;23(1):40.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Sun Y, Ji H, Sun W, An X, Lian F. Triglyceride glucose (TyG) index: a promising biomarker for diagnosis and treatment of different diseases. Eur J Intern Med. 2025;131:3–14.

    PubMed 

    Google Scholar 

  • Ma X, Dong L, Shao Q, Cheng Y, Lv S, Sun Y, et al. Triglyceride glucose index for predicting cardiovascular outcomes after percutaneous coronary intervention in patients with type 2 diabetes mellitus and acute coronary syndrome. Cardiovasc Diabetol. 2020;19(1):31.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zheng R, Qian S, Shi Y, Lou C, Xu H, Pan J. Association between triglyceride-glucose index and in-hospital mortality in critically ill patients with sepsis: analysis of the MIMIC-IV database. Cardiovasc Diabetol. 2023;22(1):307.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Nie M, Jiang B, Xu Y. Association between the triglyceride-glucose index and mortality in critically ill patients: a meta-analysis. Med (Baltim). 2024;103(33):e39262.

    Google Scholar 

  • Zhang B, Liu L, Ruan H, Zhu Q, Yu D, Yang Y, et al. Triglyceride-Glucose index linked to hospital mortality in critically ill stroke: an observational multicentre study on eICU database. Front Med (Lausanne). 2020;7:591036.

    PubMed 

    Google Scholar 

  • Hu Y, Kong Y, Tian X, Zhang X, Zuo Y. Association between heavy metals and triglyceride-glucose-related index: a mediation analysis of inflammation indicators. Lipids Health Dis. 2025;24(1):46.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Liao C, Xu H, Jin T, Xu K, Xu Z, Zhu L, et al. Triglyceride-glucose index and the incidence of stroke: a meta-analysis of cohort studies. Front Neurol. 2022;13:1033385.

    PubMed 

    Google Scholar 

  • Chatterjee M, Ehrenberg A, Toska LM, Metz LM, Klier M, Krueger I, et al. Molecular drivers of platelet activation: unraveling novel targets for Anti-Thrombotic and Anti-Thrombo-Inflammatory therapy. Int J Mol Sci. 2020;21(21):7906.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Deng XL, Liu Z, Wang C, Li Y, Cai Z. Insulin resistance in ischemic stroke. Metab Brain Dis. 2017;32(5):1323–34.

    PubMed 

    Google Scholar 

  • Moore SF, Williams CM, Brown E, Blair TA, Harper MT, Coward RJ, et al. Loss of the insulin receptor in murine megakaryocytes/platelets causes thrombocytosis and alterations in IGF signalling. Cardiovasc Res. 2015;107(1):9–19.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Santilli F, Vazzana N, Liani R, Guagnano MT, Davì G. Platelet activation in obesity and metabolic syndrome. Obes Rev. 2012;13(1):27–42.

    PubMed 

    Google Scholar 

  • Hotta N, Katanosaka K, Mizumura K, Iwamoto GA, Ishizawa R, Kim HK, et al. Insulin potentiates the response to mechanical stimuli in small dorsal root ganglion neurons and thin fibre muscle afferents in vitro. J Physiol. 2019;597(20):5049–62.

    PubMed 

    Google Scholar 

  • Liu Y, Zhu B, Zhou W, Du Y, Qi D, Wang C, et al. Triglyceride-glucose index as a marker of adverse cardiovascular prognosis in patients with coronary heart disease and hypertension. Cardiovasc Diabetol. 2023;22(1):133.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Shi W, Xing L, Jing L, Tian Y, Yan H, Sun Q, et al. Value of triglyceride-glucose index for the Estimation of ischemic stroke risk: insights from a general population. Nutr Metab Cardiovasc Dis. 2020;30(2):245–53.

    PubMed 

    Google Scholar 

  • Russo B, Menduni M, Borboni P, Picconi F, Frontoni S. Autonomic nervous system in obesity and insulin-resistance-the complex interplay between leptin and central nervous system. Int J Mol Sci. 2021;22(10):5187.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Tang S, Wang H, Li K, Chen Y, Zheng Q, Meng J, et al. C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a National cohort study. Diabetol Metab Syndr. 2024;16(1):277.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Wan B, Wang S, Hu S, Han W, Qiu S, Zhu L, et al. The comprehensive effects of high-sensitivity C-reactive protein and triglyceride glucose index on cardiometabolic Multimorbidity. Front Endocrinol (Lausanne). 2025;16:1511319.

    PubMed 

    Google Scholar 

  • Ding Z, Ge M, Tan Y, Chen C, Hei Z. The triglyceride-glucose index: a novel predictor of stroke and all-cause mortality in liver transplantation recipients. Cardiovasc Diabetol. 2024;23(1):27.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Miao M, Bi Y, Hao L, Bao A, Sun Y, Du H, et al. Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke. Nutr Metab Cardiovasc Dis. 2023;33(2):399–407.

    PubMed 

    Google Scholar 

  • Yue Y, Li P, Sun Z, Wang X, Li Z, Zhang Y. Unveiling the role of stress hyperglycemia in predicting mortality for critically ill hemorrhagic stroke patients: insights from MIMIC-IV. Front Endocrinol (Lausanne). 2025;16:1558352.

    PubMed 

    Google Scholar 

  • Yang J, Zheng Y, Li C, Gao J, Meng X, Zhang K, et al. The impact of the stress hyperglycemia ratio on Short-term and Long-term poor prognosis in patients with acute coronary syndrome: insight from a large cohort study in Asia. Diabetes Care. 2022;45(4):947–56.

    PubMed 

    Google Scholar 

  • Cui K, Fu R, Yang J, Xu H, Yin D, Song W, et al. Stress hyperglycemia ratio and long-term mortality after acute myocardial infarction in patients with and without diabetes: A prospective, nationwide, and multicentre registry. Diabetes Metab Res Rev. 2022;38(7):e3562.

    PubMed 

    Google Scholar 

  • Liu J, Zhou Y, Huang H, Liu R, Kang Y, Zhu T, et al. Impact of stress hyperglycemia ratio on mortality in patients with critical acute myocardial infarction: insight from American MIMIC-IV and the Chinese CIN-II study. Cardiovasc Diabetol. 2023;22(1):281.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zhou Y, Liu L, Huang H, Li N, He J, Yao H, et al. Stress hyperglycemia ratio and in-hospital prognosis in non-surgical patients with heart failure and type 2 diabetes. Cardiovasc Diabetol. 2022;21(1):290.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Chen L, Zeng X, Zou W, Chen M, Fan Y, Huang P. Predictive performance of stress hyperglycemia ratio for poor prognosis in critically ill patients: a systematic review and dose-response meta-analysis. Eur J Med Res. 2025;30(1):613.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Joya A, Plaza-García S, Padro D, Aguado L, Iglesias L, Garbizu M, et al. Multimodal imaging of the role of hyperglycemia following experimental subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2024;44(5):726–41.

    PubMed 

    Google Scholar 

  • Wei X, Zhou Y, Song J, Zhao J, Huang T, Zhang M, et al. Hyperglycemia aggravates blood-brain barrier disruption following diffuse axonal injury by increasing the levels of inflammatory mediators through the PPARγ/Caveolin-1/TLR4 pathway. Inflammation. 2023;46(1):129–45.

    PubMed 

    Google Scholar 

  • Zhong W, Chen R, Zhao J, Zhang Y, He J, Wang H, et al. SETD7 drives diabetic endothelial dysfunction through FBXO45-mediated GPX4 ubiquitylation. Cardiovasc Diabetol. 2025;24(1):178.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zhong W, Dong YJ, Hong C, Li YH, Xiao CX, Liu XH, et al. ASH2L upregulation contributes to diabetic endothelial dysfunction in mice through STEAP4-mediated copper uptake. Acta Pharmacol Sin. 2024;45(3):558–69.

    PubMed 

    Google Scholar 

  • Huang YQ, Gu X, Chen X, Du YT, Chen BC, Sun FY. BMECs ameliorate high glucose-Induced morphological aberrations and synaptic dysfunction via VEGF-mediated modulation of glucose uptake in cortical neurons. Cell Mol Neurobiol. 2023;43(7):3575–92.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Luo E, Li Z, Zhang S, Wen Y, Yang Z, Zeng H, et al. Hyperglycemia induces microglial pyroptosis by increasing oxygen extraction rate: implication in neurological impairment during ischemic stroke. Mol Med Rep. 2024;30(2):146.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Yen S, Wang Y, Liao LD. Exploring the translational impact of type 1 diabetes on cerebral neurovascular function through ECoG-LSCI. APL Bioeng. 2024;8(3):036108.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Sahakyan G, Vejux A, Sahakyan N. The role of oxidative Stress-Mediated inflammation in the development of T2DM-Induced diabetic nephropathy: possible preventive action of tannins and other oligomeric polyphenols. Molecules. 2022;27(24):9035.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Zhu H, Li B, Huang T, Wang B, Li S, Yu K, et al. Update in the molecular mechanism and biomarkers of diabetic retinopathy. Biochim Biophys Acta Mol Basis Dis. 2025;1871(5):167758.

    PubMed 

    Google Scholar 

  • Wang Z, Fan L. Does stress hyperglycemia in diabetic and non-diabetic acute ischemic stroke patients predict unfavorable outcomes following endovascular treatment? Neurol Sci. 2023;44(5):1695–702.

    PubMed 

    Google Scholar 

  • Huang YW, Li ZP, Yin XS. Stress hyperglycemia and risk of adverse outcomes in patients with acute ischemic stroke: a systematic review and dose-response meta-analysis of cohort studies. Front Neurol. 2023;14:1219863.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Li M, Cui X, Zhang Y, Lang J, Hao T, Su Y, et al. The relative and combined ability of triglyceride-glucose index and stress hyperglycemia ratio to predict major adverse cardio-cerebral events in patients with multivessel coronary artery disease. Diabetol Metab Syndr. 2024;16(1):234.

    PubMed 
    PubMed Central 

    Google Scholar 

  • Chen X, Shi C, Wang Y, Yu H, Zhang Y, Zhang J, et al. The mechanisms of glycolipid metabolism disorder on vascular injury in type 2 diabetes. Front Physiol. 2022;13:952445.

    PubMed 
    PubMed Central 

    Google Scholar 

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