Association of HMGB1 Levels with Stroke Severity and Clinical Outcomes in Ischemic Stroke Patients With and Without Type 2 Diabetes Mellitus

Abstract

Background: High-mobility group box 1 (HMGB1) is an inflammatory mediator implicated in ischemic stroke and type 2 diabetes mellitus (T2DM); however, its prognostic value in diabetic stroke patients remains uncertain.

Objective: To assess the association between serum HMGB1 levels, stroke severity, and clinical outcomes in ischemic stroke patients with and without T2DM.

Methods: This multicenter cross-sectional study enrolled adult patients with acute ischemic stroke in Makassar, Indonesia. Serum HMGB1 levels were measured within 24 hours of admission. Stroke severity and functional outcomes were evaluated using the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) at day 1 and day 30. Correlation analyses were performed.

Results: Serum HMGB1 levels did not differ significantly between patients with and without T2DM. In patients with T2DM, HMGB1 levels were not associated with NIHSS or mRS scores at day 1 or day 30, nor with fasting blood glucose or HbA1c. Significant improvements in NIHSS and mRS scores were observed at 30 days.

Conclusion: Serum HMGB1 levels were not associated with stroke severity or short-term clinical outcomes in ischemic stroke patients with T2DM, indicating limited prognostic utility as a standalone biomarker.