Elevated TyG-BMI Linked to Higher Short-Term Mortality in Critically Ill Ischemic Stroke Patients: Study Finds

Ischemic stroke, a leading cause of disability and death worldwide, requires timely risk assessment to enhance patient management in critical care settings. The triglyceride glucose-body mass index is a widely recognized marker for evaluating insulin resistance (IR) and has been strongly linked to stroke. However, the researchers note that research in this area remains limited, and existing studies have reported inconsistent findings.

To fill this knowledge gap, Ming Yu, Department of Neurology, Suining Central Hospital, Suining, China, and colleagues aimed to explore the association between TyG-BMI and 28-day mortality in critically ill ischemic stroke patients using data from the eICU database. This study seeks to bridge existing research gaps and provide more precise biomarker references for clinical use.

For this purpose, the researchers used multivariate Cox regression models to assess the impact of TyG-BMI on 28-day hospital and ICU mortality. Restricted cubic splines (RCS) were applied to examine potential nonlinear relationships, while Kaplan-Meier (K-M) curves were used to compare outcomes across different TyG-BMI groups. Subgroup analyses were also conducted to ensure result reliability and interaction.

The following were the key findings:

• The study included 1,362 critically ill ischemic stroke patients with a mean age of 68.41 ± 14.16 years, of whom 47.50% were male.
• Multivariate Cox regression analysis showed that patients in the high TyG-BMI group had significantly higher 28-day hospital mortality (HR = 1.734) and ICU mortality (HR = 2.337).
• Restricted cubic spline (RCS) analysis revealed a nonlinear positive correlation between TyG-BMI and 28-day hospital mortality.
• Below the inflection point of TyG-BMI = 380.37, each 1-SD (≈ 25.5 units) increase in TyG-BMI was linked to a 37.3% rise in 28-day hospital mortality (HR = 1.373).
• Above 380.37, each 1-SD increase in TyG-BMI led to an 87.9% decrease in 28-day hospital mortality (HR = 0.121).
• The log-likelihood ratio test yielded a P-value of 0.004.
• For 28-day ICU mortality, RCS analysis showed a significant positive linear correlation with TyG-BMI.

The researchers demonstrated that elevated TyG-BMI is significantly associated with a higher risk of short-term all-cause mortality in critically ill ischemic stroke patients in the United States. Their findings provide strong evidence to address existing uncertainties in this field, highlighting TyG-BMI as a simple and effective biomarker for identifying high-risk patients. They further emphasized that regular monitoring and managing triglycerides, blood glucose, and body weight may help reduce short-term mortality in acute IS patients or those at risk.

Reference:

Ouyang, Q., Xu, L. & Yu, M. Associations of triglyceride glucose-body mass index with short-term mortality in critically ill patients with ischemic stroke. Cardiovasc Diabetol 24, 91 (2025). https://doi.org/10.1186/s12933-025-02583-1