{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:15:48Z","timestamp":1789398948232,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Composite indices integrating inflammation, nutritional reserve, and metabolic status may improve early prognostic assessment after acute ischemic stroke (AIS). This study examined the associations of the C-reactive protein-to-albumin ratio (CAR) and the CRP\u2013triglyceride\u2013glucose index (CTI) with 90-day functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A Korean single-center stroke registry (2010\u20132016) was analyzed (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1,484). CAR and CTI were calculated from admission laboratory tests. The primary endpoint was 90-day unfavorable functional outcome defined as modified Rankin Scale 3\u20136. Associations were examined using multivariable logistic regression with standardized exposures; restricted cubic splines assessed non-linearity. Prognostic performance was evaluated using receiver operating characteristic analysis and a parsimonious model derived with penalized regression. Internal validation was performed using repeated 10-fold cross-validation, and model calibration was assessed using a calibration plot, calibration intercept, calibration slope, and Brier score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Unfavorable outcomes occurred in 414 patients (27.9%). After full adjustment, higher CAR (OR 1.25, 95% CI 1.09\u20131.43) and higher CTI (OR 1.38, 95% CI 1.19\u20131.60) were independently associated with unfavorable outcome. CTI showed an approximately linear risk gradient, whereas CAR showed evidence of a non-linear association. As single predictors, CAR and CTI yielded AUCs of 0.656 and 0.651 and outperformed albumin, triglycerides, and fasting plasma glucose. A six-variable model including sex, age, body mass index, admission NIHSS, CAR, and CTI achieved an apparent AUC of 0.837. Internal validation showed stable performance, with a mean cross-validated AUC of 0.831, mean Brier score of 0.142, calibration intercept of 0.023, and calibration slope of 1.018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CAR and CTI, derived from routine admission laboratory tests, were associated with 90-day functional outcomes after acute ischemic stroke and may aid early prognostic assessment. The derived six-variable model showed acceptable internal performance, but should be considered exploratory pending external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1790922","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:21:20Z","timestamp":1774243280000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations of inflammation-related nutritional and metabolic status indices CAR and CTI with 90-day unfavorable functional outcomes in patients with acute ischemic stroke"],"prefix":"10.3389","volume":"13","author":[{"given":"Xijun","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Yuebei People's Hospital, Shantou University Medical College","place":["Shaoguan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"The Second Department of Infectious Disease, Shanghai Fifth People's Hospital, Fudan University","place":["Shanghai, China"]},{"name":"Center of Community-Based Health Research, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeru","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangzhou Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Guangzhou Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxi","family":"Xie","sequence":"additional","affiliation":[{"name":"Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Department of Infectious Disease, Shanghai Fifth People's Hospital, Fudan University","place":["Shanghai, China"]},{"name":"Center of Community-Based Health Research, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"20","year":"2021","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1016\/S0140-6736(16)00163-X","article-title":"Endovascular thrombectomy after large-vessel 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