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. 2025 Apr 16;24(1):164.
doi: 10.1186/s12933-025-02724-6.

Joint association of triglyceride glucose index (TyG) and body roundness index (BRI) with stroke incidence: a national cohort study

Bingxue Wang #  1   2 , Liying Li #  3 , Ying Tang  1   2 , Xingwu Ran  4   5   6
Affiliations

Joint association of triglyceride glucose index (TyG) and body roundness index (BRI) with stroke incidence: a national cohort study

Bingxue Wang et al. Cardiovasc Diabetol. .

Abstract

Background: Insulin resistance (IR), as quantified by the triglyceride glucose (TyG) index, and visceral obesity, as assessed by the body roundness index (BRI), have been identified as pivotal risk factors for stroke. However, the combined impact of these two indicators on stroke risk has not been thoroughly investigated. This study aims to investigate both the separate and combined associations, as well as potential interactions, between the TyG index and/or BRI with respect to stroke incidence.

Methods: This cohort study encompassed 6621 respondents who were free of stroke at baseline from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized based on the median values of the TyG index or/and BRI. Cox proportional hazards regression models were employed to examine the associations between the TyG index alone, BRI alone, and their combined effects on stroke incidence. Both additive and multiplicative interaction effects were further estimated.

Results: Among 6621 participants aged 45 years or older, the mean (SD) age was 58.06 (8.57) years, with 2951 (44.6%) being male. During a follow-up period of up to 9 years, 743 individuals experienced stroke events. Compared to participants with low TyG index and low BRI, the adjusted hazard ratios (HRs) were as follows: 1.36 (95% confidence interval [CI] 1.05-1.75) for high TyG index alone, 1.61 (95% CI 1.27-2.05) for high BRI alone, and 1.78 (95% CI 1.40-2.26) for high TyG index and high BRI. Neither additive nor multiplicative interactions between BRI and TyG for incident stroke were statistically significant. The combination of TyG and BRI enhanced the predictive capability for stroke compared to either biomarker alone.

Conclusion: We discovered that both the TyG index and BRI are strongly associated with stroke incidence. The joint assessment of TyG and BRI enhances the predictive capability for stroke, underscoring the critical role of IR and visceral adiposity in the identification and screening of stroke risk.

Keywords: Body roundness index; CHARLS; Stroke; Triglyceride glucose index.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The CHARLS study was granted ethical approval by the Institutional Review Board of Peking University (approval number: IRB00001052-11015 for household survey and IRB00001052-11014 for blood sample), and all participants provided informed written consent. Consent for publication: The publication of this manuscript has been authorized by all authors. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Workflow of participant recruitment and screening. Abbreviations: BRI: body roundness index; TyG: triglyceride glucose
Fig. 2
Fig. 2
Kaplan–Meier plot of stroke by TyG index and BRI level. Abbreviations: BRI: body roundness index; TyG: triglyceride glucose
Fig. 3
Fig. 3
Sensitivity analysis of the combined effect of the TyG index and BRI level on stroke risk. (A) excluding participants with missing covariate data; (B) excluding participants receiving antihyperglycemic treatment or antihypertensive treatment or lipid-lowering treatment; (C) excluding participants with follow duration less than two years; (D) including participants with non-fasting blood samples Adjusted for age, sex, smoking, drinking, marital status, education level, residence, SBP, heart disease, diabetes, hypertension, hyperlipemia, kidney disease, C-reactive protein, and uric acid. Abbreviations: BRI: body roundness index; TyG: triglyceride glucose
See this image and copyright information in PMC

References

    1. GBD 2021 Stroke Risk Factor Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23(10):973–1003. - PubMed
    1. Tu WJ, Wang LD. China stroke surveillance report 2021. Mil Med Res. 2023;10(1):33. - PMC - PubMed
    1. Cheng Y, Lin Y, Shi H, Cheng M, Zhang B, Liu X, et al. Projections of the Stroke Burden at the Global, Regional, and National Levels up to 2050 Based on the Global Burden of Disease Study 2021. J Am Heart Assoc. 2024;13(23): e036142. - PMC - PubMed
    1. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979;237(3):E214-223. - PubMed
    1. Tahapary DL, Pratisthita LB, Fitri NA, Marcella C, Wafa S, Kurniawan F, et al. Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and Tryglyceride/glucose index. Diabetes Metab Syndr. 2022;16(8): 102581. - PubMed

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