The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy

BackgroundThe glucose-to-potassium ratio has shown promise as a biomarker in neurological disorders, but its prognostic value in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) continues to be uncertain. The study explores the relationship between admission GPR and 90-day functional...

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Main Authors: Dong Zhang, Ruinan Ma, Xiaoyan Qin, Zhizhang Li, Xiaoguang Zhang, Ying Ding, Yunqi Hu, Yunhua Yue
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1581747/full
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author Dong Zhang
Ruinan Ma
Xiaoyan Qin
Zhizhang Li
Xiaoguang Zhang
Ying Ding
Yunqi Hu
Yunhua Yue
author_facet Dong Zhang
Ruinan Ma
Xiaoyan Qin
Zhizhang Li
Xiaoguang Zhang
Ying Ding
Yunqi Hu
Yunhua Yue
author_sort Dong Zhang
collection DOAJ
description BackgroundThe glucose-to-potassium ratio has shown promise as a biomarker in neurological disorders, but its prognostic value in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) continues to be uncertain. The study explores the relationship between admission GPR and 90-day functional outcomes in AIS patients undergoing IVT treatment.MethodsA retrospective analysis included 649 AIS patients undergoing IVT between May 2016 and December 2023. Baseline clinical, laboratory, and imaging data were analyzed. GPR was calculated from serum glucose and potassium levels at admission. A modified Rankin Scale score of 3 to 6 at 90 days was used to define poor functional outcomes. Logistic regression and restricted cubic splines assessed the GPR-outcome relationship, adjusting for confounders. Receiver operating characteristic (ROC) analysis evaluated GPR’s predictive value.ResultsAmong 649 patients, 174 (26.8%) had poor outcomes. Median GPR was significantly higher in these patients (2.14 vs. 1.88, p < 0.001). Higher GPR independently predicted negative consequences (OR, 1.821; 95% CI, 1.340–2.473, p < 0.001). Subgroup analysis indicated a stronger association in non-diabetic patients. ROC analysis demonstrated an area under the curve (AUC) of 0.631 (95% CI, 0.585–0.677, p < 0.001) for GPR in predicting poor functional outcomes.ConclusionHigh GPR levels are independently linked to unfavorable 90-day functional outcomes in AIS patients who received IVT, suggesting its potential as a prognostic biomarker. Further studies are warranted to validate these findings.
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spelling doaj-art-b720159969f048049ced4918967f29a12025-08-20T03:24:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.15817471581747The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapyDong Zhang0Ruinan Ma1Xiaoyan Qin2Zhizhang Li3Xiaoguang Zhang4Ying Ding5Yunqi Hu6Yunhua Yue7Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Geriatrics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, ChinaBackgroundThe glucose-to-potassium ratio has shown promise as a biomarker in neurological disorders, but its prognostic value in acute ischemic stroke (AIS) after intravenous thrombolysis (IVT) continues to be uncertain. The study explores the relationship between admission GPR and 90-day functional outcomes in AIS patients undergoing IVT treatment.MethodsA retrospective analysis included 649 AIS patients undergoing IVT between May 2016 and December 2023. Baseline clinical, laboratory, and imaging data were analyzed. GPR was calculated from serum glucose and potassium levels at admission. A modified Rankin Scale score of 3 to 6 at 90 days was used to define poor functional outcomes. Logistic regression and restricted cubic splines assessed the GPR-outcome relationship, adjusting for confounders. Receiver operating characteristic (ROC) analysis evaluated GPR’s predictive value.ResultsAmong 649 patients, 174 (26.8%) had poor outcomes. Median GPR was significantly higher in these patients (2.14 vs. 1.88, p < 0.001). Higher GPR independently predicted negative consequences (OR, 1.821; 95% CI, 1.340–2.473, p < 0.001). Subgroup analysis indicated a stronger association in non-diabetic patients. ROC analysis demonstrated an area under the curve (AUC) of 0.631 (95% CI, 0.585–0.677, p < 0.001) for GPR in predicting poor functional outcomes.ConclusionHigh GPR levels are independently linked to unfavorable 90-day functional outcomes in AIS patients who received IVT, suggesting its potential as a prognostic biomarker. Further studies are warranted to validate these findings.https://www.frontiersin.org/articles/10.3389/fneur.2025.1581747/fullintravenous thrombolysisGPRfunctional outcomeacute ischemic strokebiomarkers
spellingShingle Dong Zhang
Ruinan Ma
Xiaoyan Qin
Zhizhang Li
Xiaoguang Zhang
Ying Ding
Yunqi Hu
Yunhua Yue
The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
Frontiers in Neurology
intravenous thrombolysis
GPR
functional outcome
acute ischemic stroke
biomarkers
title The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
title_full The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
title_fullStr The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
title_full_unstemmed The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
title_short The glucose-to-potassium ratio: a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
title_sort glucose to potassium ratio a predictor of poor functional outcomes in stroke patients receiving thrombolytic therapy
topic intravenous thrombolysis
GPR
functional outcome
acute ischemic stroke
biomarkers
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1581747/full
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