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. 2021 Feb 18;20(1):46.
doi: 10.1186/s12933-021-01238-1.

Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up

Anxin Wang #  1   2 , Guangyao Wang #  1   2 , Qian Liu  3 , Yingting Zuo  4 , Shuohua Chen  5 , Boni Tao  6 , Xue Tian  4 , Penglian Wang  1   2 , Xia Meng  1   2 , Shouling Wu  7 , Yongjun Wang  8   9 , Yilong Wang  10   11
Affiliations

Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up

Anxin Wang et al. Cardiovasc Diabetol. .

Abstract

Background: Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort.

Methods: A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006-2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression.

Results: During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12-1.33, and adjusted HR 1.32, 95% CI 1.21-1.44, respectively, P for trend < 0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes.

Conclusions: Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.

Keywords: Insulin resistance; Stroke; Triglyceride-glucose index.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves of incidence of outcomes according to quartiles of baseline TyG index. a Stroke; b Ischemic stroke; c Intracerebral hemorrhage. Q1: quartile 1; Q2: quartile 2; Q3: quartile 3; Q4: quartile 4
Fig. 2
Fig. 2
Adjusted hazard ratios of outcomes according to baseline TyG index. a Stroke; b Ischemic stroke; c Intracerebral hemorrhage. Data were fitted using a Cox regression model of restricted cubic spline with five knots (at the 5th, 25th, 50th, 50th, 75th and 95th percentiles) adjusting for potential covariates. The reference point for TyG index was the median of the reference group. Red lines indicate adjusted hazard ratio, and blue lines indicate the 95% confidence interval bands
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References

    1. Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Horwitz RI. Insulin resistance and risk for stroke. Neurology. 2002;59:809–815. doi: 10.1212/WNL.59.6.809. - DOI - PubMed
    1. Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, et al. Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke. Neurology. 2003;60:1447–1451. doi: 10.1212/01.WNL.0000063318.66140.A3. - DOI - PubMed
    1. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6:299–304. doi: 10.1089/met.2008.0034. - DOI - PubMed
    1. Guerrero-Romero F, Villalobos-Molina R, Jiménez-Flores JR, Simental-Mendia LE, Méndez-Cruz R, Murguía-Romero M, et al. Fasting triglycerides and glucose index as a diagnostic test for insulin resistance in young adults. Arch Med Res. 2016;47:382–387. doi: 10.1016/j.arcmed.2016.08.012. - DOI - PubMed
    1. Barzegar N, Tohidi M, Hasheminia M, Azizi F, Hadaegh F. The impact of triglyceride-glucose index on incident cardiovascular events during 16 years of follow-up: Tehran lipid and glucose study. Cardiovasc Diabetol. 2020;19:155. doi: 10.1186/s12933-020-01121-5. - DOI - PMC - PubMed

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