Xiaohang Su, Jueyu Zhao, Yifan Li, Xin Li
Almost half of the participating Arab children, adolescents, and young adults with diabetes reported being permitted to fast during Ramadan. Older patients were more likely to be permitted to fast and completed more fasting days, and insulin pump users were more likely to be permitted to fast than those on multiple daily injections. A weak positive association was observed between counseling scores and the number of completed fasting days.
BACKGROUND: Post-stroke depression (PSD) is a common complication after stroke that affects prognosis. The triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, is associated with cerebrovascular diseases, but its relationship with PSD remains unclear. This study investigated the association between TyG index and PSD risk in first-ever acute ischemic stroke (AIS) patients.
METHODS: We enrolled 398 consecutive first-ever AIS patients and calculated baseline TyG index. PSD was assessed using the 17-item Hamilton Depression Rating Scale at 3 months post-stroke. Logistic regression, restricted cubic splines (RCS), and threshold effect models were used to evaluate the association and dose-response relationship.
RESULTS: At 3 months, 126 patients (31.66%) developed PSD. The PSD group had significantly higher TyG index than the non-PSD group (9.03[8.34-9.34] vs. 8.56[8.17-9.05], P < 0.001). After adjusting for sex, NIHSS score, LDL-C, and HDL-C, TyG index remained independently associated with PSD (OR = 1.64, 95% CI: 1.28-2.09, P < 0.001). Patients in the highest TyG quartile had a significantly increased PSD risk compared with the lowest quartile (OR = 3.40, 95% CI:1.73-6.68, P < 0.001). RCS analysis revealed a non-linear relationship, with a turning point at 8.02 identified by threshold effect analysis; above this value, PSD risk increased significantly (OR = 1.97, 95% CI:1.43-2.72, P < 0.001). Subgroup analyses showed significant interactions in patients with diabetes (P for interaction = 0.046) and hyperlipidemia (P for interaction = 0.026).
CONCLUSIONS: Elevated TyG index is independently associated with increased PSD risk in a non-linear manner. A TyG index ≥ 8.02 may serve as a risk threshold for PSD, and this association appears more pronounced in patients with diabetes or hyperlipidemia.