Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Triglyceride-glucose index and the risk of stroke and its subtypes in the general population: an 11-year follow-up
First author：Anxin Wang,Guangyao Wang
Corresponding author：Yongjun Wang,Yilong Wang
essential_information
- Person in charge：Anxin Wang,Guangyao Wang
- Data Sources： Kailuan Study
- Number of papers：KAILUAN STUDY20200163
- Published time：2021-02-18
2021-02-18
Published articles
Journal：Cardiovascular Diabetology
Publication type: Article
IF(IF): 9.951
PMID: 33602208 Link To Pubmed Full text Download
Background And Purpose
Insulin resistance was a risk factor of stroke.[1, 2] A reliable surrogate marker of insulin resistance was recently suggested to be the triglyceride glucose index, which is calculated using fasting triglyceride and fasting glucose measurements.[3, 4] Recently, a cross-sectional study showed that the elevated levels of triglyceride glucose index was associated with a higher risk of ischemic stroke in a general population.[5] However, the association between triglyceride glucose index and risk of future ischemic stroke in a cohort study is unclear. We aim to investigate the association between triglyceride glucose index at baseline and the risk of ischemic stroke in the Kailuan Study. Furthermore, we aim to assess the association between trajectories of triglyceride glucose index and the risk of ischemic stroke.
Method
A total of 97,653 participants free of history of stroke in the Kailuan Study were included. TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Baseline TyG index was measured during 2006-2007. Updated cumulative average TyG index used all available TyG index from baseline to the outcome events of interest or the end of follow up. The outcome was the first occurrence of stroke, including ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage. The associations of TyG index with outcomes were explored with Cox regression.
Conclusion
Elevated levels of both baseline and long-term updated cumulative average TyG index can independently predict stroke and ischemic stroke but not intracerebral hemorrhage in the general population during an 11-year follow-up.
Main results
During a median of 11.02 years of follow-up, 5,122 participants developed stroke of whom 4,277 were ischemic stroke, 880 intracerebral hemorrhage, and 144 subarachnoid hemorrhage. After adjusting for confounding variables, compared with participants in the lowest quartile of baseline TyG index, those in the third and fourth quartile were associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.12-1.33, and adjusted HR 1.32, 95%CI 1.21-1.44, respectively, P for trend <0.001). We also found a linear association between baseline TyG index with stroke. Similar results were found for ischemic stroke. However, no significant associations were observed between baseline TyG index and risk of intracranial hemorrhage. Parallel results were observed for the associations of updated cumulative average TyG index with outcomes.