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image of Association of Stress Hyperglycemia Ratio, and Glucose-albumin Ratio with 90-day Prognosis in Acute Ischemic Stroke Mediating Role of Systemic Inflammatory Response Index

Abstract

Introduction

The impact of integrated glycemic indices on acute ischemic stroke (AIS) prognosis remains unclear. This study assessed the correlation between the stress hyperglycemia ratio (SHR) and the glucose-to-albumin ratio (GAR), mediated by the systemic inflammatory response index (SIRI), and their effects on the 90-day prognosis of AIS patients.

Methods

Between January 2017 and November 2023, 5,313 AIS patients were registered in the Nanjing Stroke Registry. The links are as follows: SHR, GAR, and neurological deficits after AIS were statistically evaluated univariate logistic regression analysis (ULRA) and multivariate logistic regression analysis (MLRA). Subgroup analyses were conducted to confirm the stability of the outcome. Finally, a mediation analysis of the SIRI was undertaken to investigate the relationship between hyperglycemia status and the outcomes of AIS.

Results

Depending on the modified Rankin scale (mRS) score, there were 815 patients with a poor outcome and 4,498 patients with a better outcome during the mean 90-day follow-up period. ULRA and MLRA revealed that SHR and GAR were strongly related to adverse stroke outcomes after adjusting for covariates. The SHR (Model III: OR = 1.12, 95% CI, (1.03-1.22), = 0.006). GAR (Model III: OR = 1.22, 95% CI, 1.12-1.34, < 0.001). SIRI mediated 28.4% (SHR) and 17.2% (GAR) of these effects.

Discussion

Our findings suggest that both SHR and GAR are independently associated with poor 90-day outcomes in AIS patients, and these associations are partially mediated by SIRI. This highlights the interplay between hyperglycemia, inflammation, and stroke prognosis.

Conclusion

This study highlighted that SHR and GAR were positively correlated with adverse clinical and mortality outcomes in AIS patients at 90 days, partly mediated by the SIRI.

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2025-12-04
2026-01-26

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Association of Stress Hyperglycemia Ratio, and Glucose-albumin Ratio with 90-day Prognosis in Acute Ischemic Stroke Mediating Role of Systemic Inflammatory Response Index
Bentham Science Publishers ; https://doi.org/10.2174/0115672026421915251115074018
/content/journals/cnr/10.2174/0115672026421915251115074018
/content/journals/cnr/10.2174/0115672026421915251115074018
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  • Article Type:     Research Article
Keywords: acute ischemic stroke ; mediation analysis ; 90-day adverse prognosis ; stress hyperglycemia ratio (SHR) ; systemic inflammatory response index (SIRI) ; modified Rankin Scale (mRS) ; Glucose to albumin ratio (GAR)

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