Background The triglyceride–glucose index (TyG index), an alternative indicator of peripheral insulin resistance (IR), is associated with cardiovascular disease (CVD) in the general population. The aim of this research was to determine the correlation between early-onset stroke and the TyG index among young Chinese adults. Methods Participants (age ≤ 40 years) who attended their first physical examination in Kailuan General Hospital or its 11 subsidiary hospitals between 2006 and 2012 were enrolled. The subjects were divided into four equal points according to the quartile of the TyG index, with the lowest quartile (Q1) as the reference group. A Cox proportional hazard model was employed to assess the correlation between early-onset stroke incidence and the TyG index. Restricted cubic spline analysis was further conducted to examine nonlinear associations. The TyG index was calculated as Ln [Triglyceride (TG, mg/dL) × Fasting Blood Glucose (FBG, mg/dL)/2]. Results Overall, 35,999 subjects met the inclusion criteria. Their mean age was 30.8 ±  5.7 years, and 77.1% of subjects were males. During a median observation period of 11 years, 281 stroke events occurred (62 hemorrhagic strokes and 219 ischemic strokes). Compared to the Q1 group (as the lowest group), subjects in groups Q2-Q4 had significantly higher risks of early-onset stroke (P < 0.05) after adjustment for relevant confounders in the Cox proportional hazards model. Similar results were consistent with ischemic stroke. However, no significant associations were observed between the risk of hemorrhage and the baseline TyG index. The restricted cubic splines revealed that the risk of stroke progressively increased with a high TyG index ≥ 8.41. Conclusions The TyG index may be a major risk factor for early-onset stroke among young Chinese adults. A TyG index ≥ 8.41 can be used as an indicator for screening high-risk stroke groups.

Background The Chinese visceral adiposity index (CVAI), a simple surrogate measure of visceral fat, is significantly associated with cardiovascular disease (CVD) risk in the general population. This study aimed to evaluate the association of cumulative CVAI (cumCVAI) exposure and its accumulation time course with CVD risk among patients with hypertension. Methods This prospective study involved 15,350 patients with hypertension from the Kailuan Study who were evaluated at least three times in the observation period of 2006 to 2014 (2006–2007, 2010–2011, and 2014–2015) and who were free of myocardial infarction and stroke before 2014. The cumCVAI was calculated as the weighted sum of the mean CVAI for each time interval (value × time). The time course of CVAI accumulation was categorized by splitting the overall accumulation into early (cumCVAI06 − 10) and late (cumCVAI10 − 14) accumulation, or the slope of CVAI versus time from 2006 to 2014 into positive and negative. Results During the 6.59-year follow-up period, 1,184 new-onset CVD events were recorded. After adjusting for confounding variables, the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD were 1.35 (1.13–1.61) in the highest quartile of cumCVAI, 1.35 (1.14–1.61) in the highest quartile of the time-weighted average CVAI, 1.26 (1.12–1.43) in those with a cumulative burden > 0, and 1.43 (1.14–1.78) for the group with a 10-year exposure duration. When considering the time course of CVAI accumulation, the HR (95% CI) for CVD was 1.33 (1.11–1.59) for early cumCVAI. When considering the combined effect of cumCVAI accumulation and its time course, the HR (95% CI) for CVD was 1.22 (1.03–1.46) for cumCVAI ≥ median with a positive slope. Conclusions In this study, incident CVD risk depended on both long-term high cumCVAI exposure and the duration of high CVAI exposure among patients with hypertension. Early CVAI accumulation resulted in a greater risk increase than later CVAI accumulation, emphasizing the importance of optimal CVAI control in early life.

ObjectiveThe triglyceride-glucose (TyG) index is considered as a pivotal factor for various metabolic, cardiovascular, and cerebrovascular diseases. However, there is currently a paucity of relevant studies on the association between long-term level and change of TyG-index and cardiometabolic diseases (CMDs) risk. We aimed to explore the risk of CMDs in relation to the long-term level and change of TyG-index.MethodsBased on the prospective cohort study, a total of 36359 subjects who were free of CMDs, had complete data of triglyceride (TG) and fasting blood glucose (FBG) and underwent four health check-ups from 2006 to 2012 consecutively were followed up for CMDs until 2021. The associations between long-term level and change of TyG-index and CMDs risk were assessed by Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). The TyG-index was calculated as ln [TG, mg/dL) × FBG, mg/dL)/2].ResultsDuring the median observation period of 8 years, 4685 subjects were newly diagnosed with CMDs. In multivariable-adjusted models, a graded positive association was observed between CMDs and long-term TyG-index. Compared with the Q1 group, subjects with the Q2-Q4 group had increased progressively risk of CMDs, with corresponding HRs of 1.64(1.47-1.83), 2.36(2.13-2.62), 3.15(2.84-3.49), respectively. The association was marginally attenuated, after further adjustment for the baseline TyG level. In addition, compared with stable TyG level, both loss and gain in TyG level were associated with increased CMDs risk.ConclusionsLong-term elevated level and change of TyG-index are risk factors for the incident CMDs. Elevated TyG-index in the early stage remains to exert cumulative effects on the occurrence of CMDs even after accounting for the baseline TyG-index.