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Association Between the Cholesterol-HDL-Glucose (CHG) Index and 90-Day Functional Outcomes in Patients with Acute

Xinyue Yuan1, Xiangqi Kong1, Mina Zhao1

  • 1Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.

Brain and Behavior
|June 4, 2026
PubMed

Insights

The novel Cholesterol, High-density Lipoprotein (HDL), and Glucose (CHG) index predicts poor outcomes in acute ischemic stroke (AIS) patients. Higher CHG index levels indicate a greater risk of unfavorable functional outcomes within 90 days.

Area of Science:

  • Neurology
  • Metabolic Medicine
  • Biomarker Discovery

Background:

  • Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide.
  • Metabolic disturbances like insulin resistance and dyslipidemia are associated with poorer AIS prognosis.
  • The prognostic value of the Cholesterol, High-density Lipoprotein (HDL), and Glucose (CHG) index in AIS is not well-established.

Purpose of the Study:

  • To investigate the association between the CHG index and 90-day functional outcomes in patients with AIS.
  • To determine if the CHG index can serve as an independent predictor of outcomes in AIS.
  • To evaluate the CHG index as a potential tool for early risk stratification in AIS.

Main Methods:

  • Retrospective analysis of 541 AIS patients excluding those receiving reperfusion therapy or with severe comorbidities.
  • Calculation of the CHG index upon admission using the formula: CHG = ln{[(TC × FBG) / (2 × HDL)]× 18.02}.
  • Definition of unfavorable functional outcome as modified Rankin Scale >2 at 90 days post-stroke.

Main Results:

  • 193 (35.7%) patients experienced unfavorable outcomes at 90 days.
  • Elevated CHG index levels were significantly associated with an increased risk of unfavorable outcomes.
  • Each unit increase in CHG correlated with a 1.75-fold increase in odds of unfavorable outcomes (OR=1.7516); the highest quartile showed a 3.13-fold increase compared to the lowest (p<0.05).

Conclusions:

  • The CHG index is an independent and accessible predictor of 90-day functional outcomes in AIS.
  • The CHG index effectively captures integrated metabolic stress, making it a valuable biomarker.
  • This index can aid in the early risk stratification of AIS patients for improved management.
Abstract

Keywords:
CHG indexacute ischemic strokemetabolic stressmodified Rankin Scaleprognosis

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