Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Cardiovasc Diabetol. 2021 Feb 18;20(1):46. doi: 10.1186/s12933-021-01238-1.
Triglyceride-glucose (TyG) index was recently suggested to be a reliable surrogate marker of insulin resistance. We aim to investigate the associations between baseline and long-term TyG index with subsequent stroke and its subtypes in a community-based cohort.
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.
During a median of 11.02 years of follow-up, 5122 participants developed stroke of whom 4277 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.
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.
甘油三酯-葡萄糖（TyG）指数最近被认为是胰岛素抵抗的可靠替代标志物。我们旨在研究基线和长期 TyG 指数与社区队列中随后发生的中风及其亚型之间的关联。
共有 97653 名无中风病史的 Kailuan 研究参与者被纳入研究。TyG 指数的计算方法为 ln（空腹甘油三酯[mg/dL]×空腹血糖[mg/dL]/2）。基线 TyG 指数在 2006-2007 年期间进行测量。更新的累积平均 TyG 指数使用从基线到感兴趣的结局事件或随访结束时所有可用的 TyG 指数。结局是首次发生中风，包括缺血性中风、脑出血和蛛网膜下腔出血。使用 Cox 回归探讨 TyG 指数与结局之间的关系。
在中位 11.02 年的随访期间，有 5122 名参与者发生中风，其中 4277 例为缺血性中风，880 例为脑出血，144 例为蛛网膜下腔出血。在调整混杂因素后，与基线 TyG 指数最低四分位的参与者相比，第三和第四四分位的参与者发生中风的风险增加（调整后的危险比[HR] 1.22，95%置信区间[CI] 1.12-1.33，和调整后的 HR 1.32，95% CI 1.21-1.44，P 趋势<0.001）。我们还发现基线 TyG 指数与中风之间存在线性关联。对于缺血性中风也得到了类似的结果。然而，基线 TyG 指数与脑出血风险之间没有显著关联。更新的累积平均 TyG 指数与结局之间的关联也观察到了类似的结果。
在一般人群中，基线和长期更新的累积平均 TyG 指数的升高水平可独立预测中风和缺血性中风，但不能预测脑出血，随访 11 年后。
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