Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Predictive effect of triglyceride-glucose index on clinical events in patients with acute ischemic stroke and type 2 diabetes mellitus
First author：Dong Liu
Corresponding author：Yilong Wang
essential_information
- Person in charge：Dong Liu
- Data Sources： Golden Bridge
- Number of papers：GOLDEN BRIDGE20210082
- Published time：2022-12-12
2022-12-12
Published articles
Journal：Cardiovascular Diabetology
Publication type: Article
IF(IF): 8.949
PMID: 36510223 Link To Pubmed Full text Download
Background And Purpose
The high level of triglyceride (TG) and the low level of high-density lipoprotein cholesterol (HDL-C) are associated with insulin resistance, type 2 diabetes and thus metabolic syndrome. And, Low-density lipoprotein cholesterol (LDL-C) plays a basic metabolic role in the pathogens of cardiovascular disease. Our study aimed to evaluate associations between TG/HDL-C, LDL-C/HDL-C ratios and ischemic stroke and TIA in diabetes mellitus patients.
Method
Among 19604 patients with acute IS admitted to the China National Stroke Registry II (CNSRII), 3359 IS patients with T2DM were included in the cross-sectional analysis. The TyG index (calculated by ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]) was split into four quartiles. The outcomes included recurrent IS, all-cause death and poor outcome at 1 year were analyzed. The association between the TyG index and adverse cerebrovascular outcomes was assessed by proportional hazards regression analysis.
Conclusion
TyG index is strongly related to the IS recurrence and all-cause death in acute IS patients with T2DM. This finding indicates that the TyG index might be a potential predictor of clinical outcome for acute IS patients with T2DM.
Main results
During 1 year follow-up, recurrent IS, all-cause death and poor outcome occurred in 305 (9.08%), 229 (6.82%) and 443 (47.9%) cases, respectively. Multivariable Cox proportional hazards analyses showed that the risk of incident primary endpoints was associated with a higher TyG quartile. After adjustment for confounding factors, patients with a higher TyG index had an association with IS recurrence (adjusted hazard ratio, 1.41; 95% confidence interval, 0.97-2.03; P = 0.048) and all-cause death (adjusted hazard ratio, 1.70; 95% confidence interval, 1.062-2.74; P = 0.028), compared with those in the first quartile at 1 year time follow-up. In addition, there were interactions between TyG index and age (≥65), female, hypertensive agents, anticoagulant agents, statins and antidiabetic agents in subgroup analyses, especially patients without taken anticoagulant drugs were significantly related to IS recurrence, all-cause death and poor outcome (P = 0.003, P = 0.006 and P = 0.001, respectively).