Association between the triglyceride-glucose index and functional outcome at discharge in patients receiving standardized treatment for atherosclerotic and cardioembolic stroke.
Zhu N, Zhong W, et al. • Frontiers in neurology • 2026
The TyG index was identified as a risk factor for poor functional outcome at discharge in large artery atherosclerotic stroke but was not correlated with functional outcome at discharge in cardioembolic stroke.
Key Findings
Results
Patients with poor functional outcome at discharge had a higher TyG index than those with good functional outcome.
A total of 854 patients were included: 712 with large artery atherosclerotic (LAA) stroke and 142 with cardioembolism (CE) stroke.
187 patients were categorized into the poor functional outcome group based on modified Rankin Scale (mRS) score at discharge.
The TyG index in the poor functional outcome group was higher than in the good functional outcome group (8.98 vs. 8.69).
Functional outcome groups were defined using the modified Rankin Scale (mRS) score at discharge.
Results
There was a nonlinear association between the TyG index and discharge-level functional outcome among LAA stroke patients.
A restricted cubic spline curve revealed the nonlinear association between the TyG index and discharge-level functional outcome in LAA stroke patients.
The p-value for nonlinearity was 0.026.
This nonlinear relationship was specific to the LAA stroke subgroup.
Results
The highest quartile of TyG index (TyG-Q4) was an independent risk factor for poor functional outcome at discharge in LAA stroke patients.
In unadjusted multivariate logistic regression, TyG-Q4 was associated with poor functional outcome compared to TyG-Q1 (OR = 2.63, 95% CI = 1.52–4.55).
TyG-Q2 and TyG-Q3 groups were not associated with discharge-level functional outcome compared with the TyG-Q1 group.
After adjusting for age, NIHSS score at admission, glucose, diastolic blood pressure, uric acid, and low-density lipoprotein, TyG-Q4 remained a significant risk factor (OR = 2.38, 95% CI = 1.03–5.51).
Data were collected retrospectively from two hospitals: Lianyungang Second People's Hospital and Lianyungang First People's Hospital.
Results
The TyG index did not correlate with functional outcome at discharge in the cardioembolic (CE) stroke subgroup.
The CE subgroup comprised 142 patients.
No statistically significant association was found between the TyG index and discharge-level functional outcome in CE stroke patients.
The authors caution that this negative result should be interpreted cautiously due to limited sample size, insufficient endpoint events, and potential inadequate statistical power.
The authors state that 'the potential predictive value of the TyG index for discharge-level functional outcome in CE stroke cannot be excluded.'
Methods
The study design was a retrospective analysis using logistic regression to evaluate TyG index as a predictor of stroke functional outcomes.
Baseline data, neurological scale scores, and laboratory indicators were retrospectively collected.
Patients were categorized into good and poor functional outcome groups based on mRS score at discharge.
A logistic regression model was used to evaluate the relationship between the TyG index and functional outcome.
Covariates adjusted for included age, NIHSS score at admission, glucose, diastolic blood pressure, uric acid, and low-density lipoprotein.
Conclusions
The authors call for large-scale clinical studies to further explore the predictive value of the TyG index in cardioembolic stroke.
The negative CE subgroup result was attributed to limited sample size (n = 142) and insufficient statistical power.
The authors state the negative CE result 'should not be over-interpreted.'
'Large-scale clinical studies are required to further explore the potential prognostic value of the TyG index in cardioembolic stroke.'
What This Means
This research suggests that a blood test measure called the triglyceride-glucose (TyG) index — calculated from fasting triglyceride and blood glucose levels — may help predict how well patients recover from a specific type of stroke called large artery atherosclerotic (LAA) stroke, which is caused by plaque buildup in blood vessels. Among 712 LAA stroke patients studied, those with the highest TyG index values (top quartile) were more than twice as likely to have poor functional outcomes at hospital discharge compared to those with the lowest values, even after accounting for other risk factors like age, stroke severity, and cholesterol levels. The relationship between TyG and outcomes was nonlinear, meaning risk rose most sharply at the highest levels of the index.
For a second type of stroke called cardioembolic (CE) stroke — caused by blood clots traveling from the heart — no significant association was found between TyG index and functional outcomes. However, this finding comes with an important caveat: only 142 CE stroke patients were included in the study, which may not have been enough to detect a real effect if one exists. The authors caution against reading too much into the negative CE result.
This research suggests that measuring the TyG index, a relatively simple and inexpensive calculation, could help identify LAA stroke patients at higher risk for poor recovery before they leave the hospital. However, because this was a retrospective study from two hospitals in China, larger and more diverse studies are needed to confirm these findings and to better understand the TyG index's role in cardioembolic stroke recovery.
Zhu N, Zhong W, Shen X, Liao J, Zhang G, Liu X. (2026). Association between the triglyceride-glucose index and functional outcome at discharge in patients receiving standardized treatment for atherosclerotic and cardioembolic stroke.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1899230