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Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
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Insulin Resistance Predicts Prognosis in Patients With Subarachnoid Hemorrhage

Pengfei Ding1,2,3, Dingding Zhang1,2,3, Haiping Ling1,2,3

  • 1Department of Neurosurgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.

Journal of Evidence-Based Medicine
|December 16, 2024
PubMed

Insights

Insulin resistance predicts poor outcomes in subarachnoid hemorrhage (SAH) patients. A model combining age, glucose, triglyceride-glucose (TyG) index, and TG/HDL ratio shows high accuracy for prognosis prediction.

Area of Science:

  • Neurology
  • Metabolic Syndrome
  • Medical Prognostics

Background:

  • Subarachnoid hemorrhage (SAH) poses significant mortality risks.
  • Predictive markers for SAH prognosis are crucial for patient management.
  • Insulin resistance (IR) is increasingly recognized for its systemic effects.

Purpose of the Study:

  • To investigate insulin resistance (IR) as a predictor of poor prognosis 3 months post-SAH.
  • To evaluate the predictive value of triglyceride-glucose (TyG) index and TG/HDL ratio for SAH outcomes.

Main Methods:

  • Retrospective analysis of 358 SAH patients (age ≥18) due to ruptured aneurysms.
  • Exclusion of patients with diabetes, specific drug use, or other systemic diseases.
  • Utilized ROC, LASSO, and logistic regression to assess TyG index and TG/HDL ratio as predictors.

Main Results:

  • Poor prognosis group showed higher age, BMI, hypertension, glucose, triglycerides, TyG index, and TG/HDL ratio; lower HDL.
  • Age, glucose, TyG index, and TG/HDL ratio were significant predictors of SAH prognosis.
  • A predictive model incorporating these factors demonstrated high discriminatory power (AUC = 0.80).

Conclusions:

  • Insulin resistance is strongly linked to poor prognosis in SAH patients.
  • A novel prognostic model combining age, glucose, TyG index, and TG/HDL ratio offers clinical utility.
  • This model may guide future therapeutic strategies for SAH.
Abstract

Keywords:
aneurysmal subarachnoid hemorrhageinsulin resistancenomogrampredictionprognosis

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