Triglyceride-glucose index, symptomatic intracranial artery stenosis and recurrence risk in minor stroke patients with hypertension

Abstract

Background The triglyceride-glucose (TyG) index, a simple measure of insulin resistance, is associated with intracranial atherosclerosis (ICAS) and stroke. In hypertensive populations, this association may be pronounced. The aim was to investigate the relationship between TyG and symptomatic intracranial atherosclerosis (sICAS) and recurrence risk in ischemic stroke patients with hypertension. Methods This prospective, multicenter cohort study included patients with acute minor ischemic stroke with a preadmission diagnosis of hypertension from September 2019 to November 2021 with a 3-month follow-up. The presence of sICAS was determined by a combination of clinical manifestations, the location of the infarction, and the corresponding artery with moderate-to-severe stenosis. ICAS burden was determined by the degree and number of ICAS occurrences. Fasting blood glucose (FBG) and triglyceride (TG) were measured to calculate TyG. The main outcome was ischemic stroke recurrence during the 90-day follow-up. Multivariate regression models were used to explore the association of TyG, sICAS, and ICAS burden with stroke recurrence. Results There were 1281 patients with a mean age of 61.6 ± 11.6 years; 70.1% were male, and 26.4% were diagnosed with sICAS. There were 117 patients who experienced stroke recurrence during follow-up. Patients were categorized according to quartiles of TyG. After adjusting for confounders, the risk of sICAS was greater (OR 1.59, 95% CI 1.04–2.43, p = 0.033) and the risk of stroke recurrence was significantly higher (HR 2.02, 95% CI 1.07–3.84, p = 0.025) in the fourth TyG quartile than in the first quartile. The restricted cubic spline (RCS) plot revealed a linear relationship between TyG and sICAS, and the threshold value for TyG was 8.4. Patients were then dichotomized into low and high TyG groups by the threshold. Patients with high TyG combined with sICAS had a higher risk of recurrence (HR 2.54, 95% CI 1.39–4.65) than patients with low TyG without sICAS. An interaction effect on stroke recurrence between TyG and sICAS was found (p = 0.043). Conclusion TyG is a significant risk factor for sICAS in hypertensive patients, and there is a synergistic effect of sICAS and higher TyG on ischemic stroke recurrence. Trial registration number: The study was registered on 16 August 2019 at https://www.chictr.org.cn/showprojen.aspx?proj=41160 (No. ChiCTR1900025214).

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. [41–47] 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]…”

“…[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.…”

Association between the triglyceride glucose index and short-term mortality in septic patients with or without obesity: a retrospective cohort study

“…The triglyceride-glucose index (TyGI) is a quantitative indicator of metabolic dysfunction, which is determined by measuring TG and FBG levels [ 20 ]. It has been established as an independent predictor in a wide variety of diseases, including metabolic and vascular diseases [ 21–23 ], hepatic diseases [ 24 ], nervous system diseases [ 25 , 26 ], acute kidney injury [ 27 , 28 ], malignancies [ 29 ] and obesity-related disorders [ 30 ]. A retrospective study highlighted a strong link between the TyGI and rising death rates in severely sick individuals [ 31 ].…”