The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis

Abstract

Background Strokes significantly impair quality of life and incur high economic and societal burdens. The triglyceride and glucose (TyG) index is a biochemical marker of insulin resistance (IR) and may have important value in the prediction of strokes, especially ischemic stroke (IS). Our study aims to investigate the relationship between TyG index and IS and ascertain whether TyG index is independently associated with IS adverse outcomes. Methods The Cochrane, Embase, Medline, Web of Science, PubMed, and other relevant English databases and related websites were systematically searched for articles on ‘‘TyG index’’ and "stroke" published from inception to April 4, 2022. We reviewed the available literature on the TyG index and its relation to predicting IS occurrence in the general population and adverse clinical outcomes. We calculated odds ratios (OR) of TyG index and its predictability of IS occurrence and adverse outcomes. Statistical analyses were performed using the Meta Package in STATA, version 12.0. Results A total of 18 studies and 592,635 patients were included in our analysis. The pooled effect values of all stroke types showed that higher TyG index was associated with increased the risk of IS in the general population (OR 1.37; 95% CI 1.22–1.54) in a total sample of 554,334 cases with a high level of heterogeneity (P = 0.000, I2 = 74.10%). In addition, compared to IS patients with a lower TyG index, IS patients with a higher TyG index was associated with higher risk of stroke recurrence (OR: 1.50; 95% CI 1.19–1.89) and increased risk of mortality (OR 1.40 95% CI 1.14–1.71). No correlation was found in the effect value combinations of poor functional outcomes (OR 1.12; 95% CI 0.88–1.43) and neurological worsening (OR: 1.76; 95% CI 0.79–3.95) in a total sample of 38,301 cases with a high level of heterogeneity (P = 0.000; I2 = 77.20%). Conclusions TyG index has potential value in optimizing risk stratification for IS in the general population. Furthermore, there is a significant association between high TyG index and many adverse outcomes of stroke, especially stroke recurrence and high mortality. Future studies should focus on multi-center and multi-regional designs in order to further explore the relationship between IS and TyG index.

Triglyceride‐glucose index's link to cardiovascular outcomes post‐percutaneous coronary intervention in China: a meta‐analysis

“…36 Yang et al included a total of 592 616 individuals in their meta-analysis and discovered the correlation between TyG index and ischaemic stroke in the general population. 37 In numerous large-scale clinical observational studies, it has been shown that the incidence of post-PCI MACE and TyG index are positively correlated. [38][39][40] There is a correlation between TyG index and prevalence of MACE in post-PCI populations; however, results of these studies have been inconsistent.…”

Elevated triglyceride-glucose index predicts mortality following endovascular abdominal aortic aneurysm repair

“…Second, TyG is usually associated with lipid and glucose metabolism disturbance, reflecting well the fat toxicity and sugar toxicity that can adversely affect cardiovascular outcomes (16,17). In addition, a higher TyG index is independently related to the occurrence and development of arterial stiffness, nephric microvascular damage and several diseases including hypertension, diabetes, stroke, coronary artery disease, non-alcoholic fatty liver and malignancy, which are identified as risk factors for early and late mortality in AAA patients after EVAR (4,(17)(18)(19). Therefore, it seems reasonable to propose that AAA subjects with higher TyG levels are more likely to experience a course of vascular and organ impairment, contributing to an increased risk of all-cause mortality after EVAR.…”

The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke

“…Studies have evaluated the TGI in many areas, including its relationships with acute coronary syndrome in patients without [27][28][29][30][31][32][33] and with type 2 diabetes, [36] body mass index, [34,35] type 2 diabetes, [37][38][39][40][41] ischemic stroke, [41][42][43][44][45][46][47] cardiovascular disorders, [51][52][53] and intravenous thrombosis. [60,61] Like our study, some studies have examined the relationship between TGI and sarcopenia.…”

“…[40] Many recent studies have investigated the relationship between TGI and ischemic stroke, especially regarding cardiovascular disease. [41][42][43][44][45][46][47] The relationships between TGI and total chronic occlusion, [48] cancer, [49] and high blood pressure, [50,51] and the relationship between acute stroke and high blood pressure in older adults, have also been evaluated in detail. [52,53] While TMT and TGI have been used as separate parameters in different studies, we aimed to examine the relationships between these parameters and sarcopenia, mortality, and thirdmonth functional outcomes in patients after acute stroke.…”

“…[40] Many recent studies have investigated the relationship between TGI and ischemic stroke, especially regarding cardiovascular disease. [41–47] The relationships between TGI and total chronic occlusion, [48] cancer, [49] and high blood pressure, [50,51] and the relationship between acute stroke and high blood pressure in older adults, have also been evaluated in detail. [52,53]…”