Korelasi Triglyceride Glucose Index, Homeostatic Model Assessment for Insulin Resistance, Glycemic Gap dan The Low-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio dengan Outcome Pasien Stroke Iskemik Akut dengan dan tanpa Diabetes Mellitus Tipe 2

Abstract

Background:. Several new studies have assessed prognostic indicators in acute ischemic stroke such as the Trygliceride Glucose Index (TyG Index), Homeostatic Model Assessment For Insulin Resistance (HOMA-IR), Low Density Lipoprotein Cholesterol To High Density Lipoprotein Cholesterol Ratio (LDL/HDL C Ratio) and Glycemic Gap (GG). There is currently limited evidence about these in Indonesia. Objective: To investigate the correlation TyG Index, HOMA-IR, LDL/HDL C Ratio, Glycemic Gap and the outcome of acute ischemic stroke patients with diabetes mellitus (DM) type 2 and non DM. Methods: This research was a cross-sectional study of acute ischemic stroke patients at Haji Adam Malik Hospital Medan and its network hospitals in January - May 2024. Researchers collected information about the patient's severity level using the National Institute Health Stroke Scale (NIHSS) on the first day and seventh day. Correlative analysis of TyG Index, HOMA-IR, LDL/HDL C Ratio, GG with the outcome of ischemic stroke patients was conducted and a multivariate analysis was carried out to see which factors had the most influence on the outcome of ischemic stroke. Results: This research was conducted on 84 samples consisting of 2 groups, namely the DM and Non DM groups. There is a correlation between TyG Index scores (r = 0,41, p = 0,07) (r = 0,471, p = 0,002), HOMA-IR (r = 0,477, p = 0,001) (r = 0,361, p = 0,019) , LDL/HDL C Ratio (r=0,374, p=0,015) (r=0,334, p=0,031), GG (r=0,342, p=0,026) (r=0,327, p=0,035) with outcomes in patients with and without DM. HOMA IR and LDL/HDL C ratio are the variables that significantly affect ischemic troke outcome with DM (r= 0,640 p<0.001) and (r= 0,700 p<0.001) while TyG Index, HOMA-IR and GG is significantly affect non DM ischemic stroke outcome non-DM patients (r= 0,644) (p=0,004, p=0,13, p=0,14). Conclusion: TyG Index, HOMA-IR, LDL/HDL C Ratio, GG associated with the outcome of acute ischemic stroke patients both DM and non DM. HOMA- IR significantly affect outcome of ischemic stroke.