{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:49:15Z","timestamp":1793717355794,"version":"4.6.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T00:00:00Z","timestamp":1741478400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Hyperglycemia and poststroke immunosuppression can lead to a decline in immune function, resulting in an increased incidence of infectious events. The relationship between the glucose\u2010to\u2010lymphocyte ratio (GLR), a novel indicator, and stroke\u2010associated pneumonia (SAP) remains unclear. The objective of this study is to investigate the early predictive value of the GLR in the context of SAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on acute stroke patients admitted to the Department of Neurology at the First Affiliated Hospital of Kunming Medical University from 2017 to 2021. The dataset included demographic information, vascular risk factors, and laboratory test results. Logistic regression analysis was used to assess the correlation between the GLR and the incidence of SAP. The GLR was converted into a categorical variable for trend testing, and compared the predictive efficiency of GLR through the receiver operating characteristic (ROC) curve and Bonferroni correction analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 711 patients with acute stroke according to a 1:2 case\u2013control ratio, with 237 (33.3%) in the SAP group and 474 (66.7%) in the Non\u2010SAP group. The baseline level of the GLR was significantly greater in the SAP group than in the Non\u2010SAP group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). After correction using multifactorial logistic regression analysis, GLR (OR: 1.182, 95% CI: 1.090\u20131.281,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) was identified as an independent risk factor for SAP. When GLR was converted into a categorical variable, the risk of SAP in group Q3 was 3.210 times greater than that in group Q1, and the trend test yielded\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001. The analysis of the ROC curve revealed that the area under the curve (AUC) for the GLR was 0.737, with a sensitivity of 70.0% and specificity of 67.1% at a cutoff value of 4.110. The predictive efficacy of the GLR for SAP patients was superior to that of either blood glucose or lymphocyte counts alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0167).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An elevated GLR within 24\u00a0h of hospital admission following an acute stroke is an independent risk factor for SAP. The risk of SAP increases progressively with increasing GLR, suggesting that the GLR may have a certain early predictive value for the occurrence of SAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.70404","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T18:34:53Z","timestamp":1741718093000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Early Predictive Value of the Glucose\u2010to\u2010Lymphocyte Ratio for the Occurrence of Stroke\u2010Associated Pneumonia"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6559-4217","authenticated-orcid":false,"given":"Fuqiang","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Neurology First Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liju","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Yunnan Key Laboratory of Laboratory Medicine First Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infection Management Office First Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology First Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Yan'an Hospital Affiliated to Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Operations Management First Affiliated Hospital of Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuankuan","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengchen","family":"Gao","sequence":"additional","affiliation":[{"name":"School of Public Health Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7885-3722","authenticated-orcid":false,"given":"Haimei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology First Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2141"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.3302"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046464"},{"issue":"1","key":"e_1_2_11_6_1","article-title":"Prevalence of Stroke\u2010Associated Pneumonia and Its Predictors Among Hyperglycaemia Patients During Acute Ischemic Stroke","volume":"16","author":"Elhefnawy M.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930211065917"},{"issue":"12","key":"e_1_2_11_8_1","first-page":"4367","article-title":"T\u2010lymphocyte Subsets as a Predictive Biomarker for Stroke\u2010Associated Pneumonia","volume":"10","author":"Feng H. X.","year":"2018","journal-title":"American Journal of Translational Research"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000350199"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000063373.70993.CD"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X16671964"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2022.2052272"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2015.11.011"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000598"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001931"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987319851335"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0295602"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021228"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-023-06803-0"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.12521"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17010064"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001307"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009617"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12956"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.1455"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1115031"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.05.002"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.871301"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1290176"},{"issue":"8","key":"e_1_2_11_30_1","first-page":"528","article-title":"Diagnosis of Acute Stroke","volume":"91","author":"Yew K. S.","year":"2015","journal-title":"American Family Physician"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2016.02.039"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24397"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003811"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.70404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T01:41:49Z","timestamp":1749433309000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.70404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/brb3.70404"],"URL":"https:\/\/doi.org\/10.1002\/brb3.70404","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1002\/BRB3.70404\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70404\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70404\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70404\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70404\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/BRB3.70404\/v2\/decision1","asserted-by":"object"}]},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70404"}}