Association of the triglyceride-glucose index with the severity and short-term prognosis of Guillain-Barré syndrome.

BACKGROUND

Guillain-Barré syndrome (GBS) is a peripheral nerve inflammatory disorder driven by immune-mediated mechanisms. Currently, there is a lack of research investigating the association between the triglyceride-glucose (TyG) index and GBS, and this study sought to explore their possible relationship.

METHODS

203 patients with GBS from Beijing Tiantan Hospital were retrospectively enrolled in this study. The relationship of the TyG index with severe and short-term poor prognosis in GBS patients was investigated using least absolute shrinkage and selection operator (LASSO) regression, binary logistic regression, restricted cubic spline (RCS) analysis and receiver operating characteristic (ROC) curve.

RESULTS

The TyG index (OR: 2.77; 95% CI: [1.51-5.30]; P = 0.001) was identified as independent risk factors for severe GBS. Conversely, albumin (ALB) (OR: 0.89; 95% CI: [0.82-0.96]; P = 0.006) and the Medical Research Council (MRC) sum score (OR: 0.93; 95% CI: [0.90-0.96]; P<0.001) acted as protective factors. Additionally, the TyG index (OR: 1.85; 95% CI: [1.05-3.32]; P = 0.036) emerged as an independent risk factor for poor short-term prognosis, whereas the MRC sum score (OR: 0.94; 95% CI: [0.91-0.96]; P<0.001) was recognized as a protective factor. Furthermore, TyG index showed a linear correlation with severe GBS (overall P<0.01, nonlinear P = 0.112) and short-term poor prognosis in GBS patients (overall P = 0.068, nonlinear P = 0.277). Used alone, the TyG index yielded area under the curve (AUC) values of 0.644 and 0.589 for predicting severe GBS and short-term poor-prognosis GBS, respectively. When combined with conventional clinical markers, the model achieved an AUC of 0.808 (sensitivity 0.732, specificity 0.776) for severe GBS and 0.765 (sensitivity 0.763, specificity 0.701) for short-term poor prognosis. Bootstrap internal validation showed optimism bias/corrected AUC of 0.008/0.800 and 0.006/0.759 for the two models. After incorporating the TyG index into the baseline model, the net reclassification index (NRI) was significantly elevated, while the integrated discrimination improvement (IDI) showed a slight improvement (all P<0.05).

CONCLUSIONS

Elevated TyG index is independently linked to higher risks of severe phenotype and short-term poor prognosis in GBS patients. Combined with conventional clinical indicators, TyG index may help predict severe cases and adverse short-term prognosis in GBS.