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. 2022 Jul 27;21(1):141.
doi: 10.1186/s12933-022-01577-7.

Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study

Zegui Huang #  1   2 , Xiong Ding #  3 , Qing Yue  4 , Xianxuan Wang  1   2 , Zekai Chen  5 , Zefeng Cai  2 , Weijian Li  1   2 , Zhiwei Cai  1   2 , Guanzhi Chen  6 , Yulong Lan  2 , Weiqiang Wu  2 , Shouling Wu  7 , Youren Chen  8
Affiliations

Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study

Zegui Huang et al. Cardiovasc Diabetol. .

Abstract

Background: It has been suggested that the baseline triglyceride-glucose (TyG) index, a simple surrogate measure for insulin resistance, is significantly associated with the occurrence of stroke. Nevertheless, the impact of longitudinal patterns of TyG on the stroke risk in hypertensive patients is still unknown. Hence, this study aimed to investigate the association between TyG index trajectory and stroke risk among hypertensive patients.

Methods: This prospective study included 19,924 hypertensive patients from the Kailuan Study who underwent three waves survey and were free of myocardial infarction, cancer and stroke before or during 2010. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2], and latent mixed modelling was used to identify the trajectory of TyG during the exposure period (2006-2010). Furthermore, the Cox proportional hazard models were applied to estimate the hazard ratio (HR) and 95% confidence interval (CI) for incident stroke of different trajectory groups.

Results: Five distinct TyG trajectory were identified during 2006-2010: low-stable (n = 2483; range, 8.03-8.06), moderate low-stable (n = 9666; range, 8.58-8.57), moderate high-stable (n = 5759; range, 9.16-9.09), elevated-stable (n = 1741; range, 9.79-9.75), and elevated-increasing (n = 275; range, 10.38-10.81). During the median follow-up of 9.97 years, 1,519 cases of incident stroke were identified, including 1,351 with ischemic stroke and 215 with hemorrhage stroke. After adjusting for confounding variables, the HR and 95% CI of stroke were 2.21 (1.49,3.28) for the elevated-increasing group, 1.43 (1.13,1.83) for the elevated-stable group, 1.35 (1.10,1.64) for the moderate high-stable group, 1.26 (1.06,1.52) for the moderate low-stable group, respectively, when compare with the low-stable group. Similar results were observed in ischemic stroke, but a significant association was not found between TyG trajectory and risk of hemorrhage stroke.

Conclusion: A long-term elevated TyG index in hypertensive patients is associated with an increased risk of stroke, especially ischemic stroke. This finding implies that regular monitoring of TyG index may assist in identifying individuals at a higher risk of stroke among patients with hypertension.

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

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Conflict of interest statement

None of the authors had any conflict of interest regarding any aspect of this manuscript.

Figures

Fig. 1
Fig. 1
Triglyceride-glucose index trajectory in hypertensive patients during 2006–2010
Fig. 2
Fig. 2
Kaplan–Meier curves of incidence of outcomes according to TyG index trajectory. a Stroke; b Ischemic stroke; c Hemorrhage stroke
See this image and copyright information in PMC

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