Elevated triglyceride–glucose index predicts risk of incident ischaemic stroke: The Rural Chinese cohort study

Zhao, Yang; Sun, Hai; Zhang, Weidong; Xi, Yang; Shi, Xiaoguang; Yang, Yongli; Lu, Jie; Zhang, Ming; Sun, Liang; Hu, Dongsheng

doi:10.1016/j.diabet.2021.101246

Cited by 56 publications

(60 citation statements)

References 31 publications

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“…Data from the Kailuan Study, 19 a study of 97,653 participants free of a history of stroke during a median of 11.02 years of follow-up by Wang et al, found that both the baseline and long-term updated cumulative average TyG index can predict stroke and ischemic stroke but not intracerebral haemorrhage. Zhao et al 22 and Hong et al 17 consistently reported that a high TyG index was significantly associated with an increased risk of stroke. In addition, a Mendelian randomization study by Si et al 18 of 273,368 individuals of European ancestry showed that the TyG index was significantly associated with several cerebrovascular diseases.…”

Section: Discussionmentioning

confidence: 98%

“…16 Several recent studies have shown an association between the TyG index and stroke in the general population. [17][18][19][20][21][22] However, to our knowledge, the role of TyG index has not been examined in such a high-risk hypertensive older adult population. Therefore, this study aimed to specifically investigate the association of the TyG index with the first stroke and first ischemic stroke among elderly individuals with hypertension in the Chinese community.…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between the Triglyceride Glucose Index and the Risk of First Stroke in Elderly Hypertensive Patients

Hu¹,

Bao²,

Huang³

et al. 2022

IJGM

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Background: Several recent studies have shown the relationship between the triglyceride glucose (TyG) index and the risk of stroke in the general population and in a few patient cohorts; however, the role of the TyG index on stroke risk in elderly hypertensive patients has not been determined. Thus, we aimed to investigate the association of the TyG index with first stroke and first ischemic stroke in elderly individuals with hypertension. Methods: We included 8487 elderly subjects with hypertension from the China H-type Hypertension Registry Study for the current analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Outcomes were the first stroke and first ischemic stroke. Results: During a median follow-up of 1.72 years, the first stroke was diagnosed in 82 patients (0.97%), and the first ischemic stroke was diagnosed in 48 patients (0.57%). Multivariable Cox proportional hazards models revealed that the TyG index was positively associated with the risk of first stroke (per 1-unit increment; HR: 1.72; 95% CI: 1.07, 2.76) and first ischemic stroke (HR: 2.31; 95% CI: 1.32, 4.05). When the TyG index was assessed as quartiles, significantly higher risks of first stroke (HR: 1.90; 95% CI: 1.04, 3.45) and first ischemic stroke (HR: 2.45; 95% CI: 1.16, 5.20) were found in participants in quartile 4 compared with those in quartiles 1-3. Conclusion:The TyG index is potentially useful in the early identification of elderly hypertensive patients at high risk of experiencing a first stroke.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Relationship Between the Triglyceride Glucose Index and the Risk of First Stroke in Elderly Hypertensive Patients

Hu¹,

Bao²,

Huang³

et al. 2022

IJGM

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“…Therefore, the one with the larger sample size was included. Finally, 11 studies were included in our systematic review and meta-analysis [7][8][9][10][11][12][13][14][15][16][17]. The complete data required for the dose-response meta-analysis was available in 7 studies [7-9, 11, 13, 15, 16] (▶ Fig.…”

Section: Studies Selectionmentioning

confidence: 99%

“…Five studies were conducted in patients with the acute coronary syndrome, two studies in patients with type 2 diabetes, and the other two studies excluded diabetes patients. Exposure factors were divided into three types: baseline TyG index (10 studies [7][8][9][10][11][12][13][14][15][16]); accumulated average TyG index (1 study [16]; The average of TyG index measured every two years from the inception to the outcome occurred or the end of the follow-up), TyG index changes (1 study [17]; The difference between the TyG index at the beginning of follow-up and the four years before the follow-up). Two articles produced by the Kailuan study observed different exposure factors [16,17].…”

Section: Study Characteristics and Quality Evaluationmentioning

confidence: 99%

Triglyceride-Glucose Index and the Risk of Stroke: A Systematic Review and Dose-Response Meta-Analysis

Feng

Yao

et al. 2022

Horm Metab Res

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Insulin resistance (IR) is an independent risk factor of cardiovascular disease. Recent research has proposed a new inexpensive and reliable indicator of IR: triglyceride glucose index (TyG index). We aim to evaluate the dose-response association between the TyG index and stroke through meta-analysis. Literature published from inception until October 2021 were searched in PubMed, Embase, Cochrane Library and Web of science. Cohort studies published in English and focusing on the association between the TyG index and stroke were included in our meta-analysis. I2 statistic and Chi-square were used to assess the heterogeneity. When I2≥30% or p≤0.10, the random-effect model was used to pool the effect; otherwise, we chose the fixed-effect model. Eleven cohort studies, including 5 721 077 subjects and 95 490 stroke patients, were included in our study. After pooling the effect adjusted by multiple confounders, we found that compared with the lowest baseline TyG index group, the highest one was independently associated with increased stroke risk (RR: 1.27; 95% CI, 1.24 to 1.29; I2=6%). Dose-response meta-analysis showed that the association between the two variables had a non-linear trend (p-nonlinearity<0.0001; p-heterogeneity=0.28). Subgroup analysis showed that the risk of ischemic stroke was positively correlated with TyG index (RR: 1.48; 95% CI, 1.34 to 1.62; I2=15%), while we did not observe this correlation in hemorrhagic stroke patients. In patients with type 2 diabetes and acute coronary syndrome, the TyG index was linearly correlated with incident strokes. In conclusion, elevated TyG index is the independent risk factor for incident strokes (especially ischemic stroke).

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“…Shi et al considered that TyG could assist in the assessment of the probability of ischemic stroke (37). In addition, an increased TyG index independently predicts the risk of ischemic stroke in the general population, and IR may be positively correlated with future stroke risk (38). Although studies have found that the correlation between BMI and stroke prognosis is not affected by the TyG index (39), it is interesting that Du et al reported an association between the TyG-BMI index derived from the TyG index and ischemic stroke (40).…”

Section: Prediction Of Macces By the Tyg Index In Prediabetic Patientsmentioning

confidence: 99%

Influence of the Triglyceride-Glucose Index on Adverse Cardiovascular and Cerebrovascular Events in Prediabetic Patients With Acute Coronary Syndrome

et al. 2022

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BackgroundCardiovascular disease and insulin resistance are closely related. The triglyceride-glucose (TyG) index is frequently used as an indicator of insulin resistance. However, there is scant information on the TyG index in the prediabetic population, nor is the prognostic significance of the index known for prediabetes and acute coronary syndrome (ACS) patients.MethodsThe clinical endpoint was a major adverse cardiovascular and cerebrovascular event (MACCEs), including cardiac-related death, non-fatal myocardial infarction, ischemia-driven revascularization, and stroke. The TyG index was calculated as = ln [(triglyceride level, mg/dL) × (glucose level, mg/dL)÷2] under fasting conditions.ResultsThe study included 2,030 prediabetic patients with ACS. Patients were followed up for 2.5 years, during which the total incidence of MACCEs was 12%. After adjustment for covariates, the TyG index was found to be predictive of prediabetes with ACS (HR 4.942, 95%CI: 3.432-6.115, P<0.001). Using propensity score matching, 574 pairs were successfully matched, and the two groups were analyzed in terms of survival. This showed that there was a significantly greater incidence of MACCEs in patients with high TyG indices (HR 3.526, 95%CI: 2.618-4.749, P<0.001), mainly due to ischemia-driven revascularization and stroke.ConclusionsThe TyG index independently predicts future MACCEs and may be an important prognostic indicator for patients with prediabetes and ACS.

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Elevated triglyceride–glucose index predicts risk of incident ischaemic stroke: The Rural Chinese cohort study

Cited by 56 publications

References 31 publications

Relationship Between the Triglyceride Glucose Index and the Risk of First Stroke in Elderly Hypertensive Patients

Relationship Between the Triglyceride Glucose Index and the Risk of First Stroke in Elderly Hypertensive Patients

Triglyceride-Glucose Index and the Risk of Stroke: A Systematic Review and Dose-Response Meta-Analysis

Influence of the Triglyceride-Glucose Index on Adverse Cardiovascular and Cerebrovascular Events in Prediabetic Patients With Acute Coronary Syndrome

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