Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Cardiovascular Department, Zhengzhou Yihe Hospital Affiliated to Henan University, Zhengzhou, Henan, People's Republic of China.
Diabetes Metab. 2021 Jul;47(4):101246. doi: 10.1016/j.diabet.2021.101246. Epub 2021 Mar 12.
As the association between insulin resistance and ischaemic stroke is conflicting, our study aimed to examine the association between triglyceride-glucose (TyG), a surrogate marker of insulin resistance, and incident ischaemic stroke, and also to further assess the potential effect of modification by several known risk factors of stroke.
The Rural Chinese Cohort Study enrolled 11,777 participants, aged ≥40 years, who were free of stroke and cardiovascular disease at baseline during 2007-2008, and who were then followed during 2013-2014. TyG was determined using the following formula: Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The relative risk (RR) and 95% confidence interval (CI) of incident ischaemic stroke associated with TyG were estimated using modified Poisson regression models.
During a median follow-up duration of 6 years, 677 new ischaemic stroke cases were identified. After multivariate adjustment, RR (95% CI) values for ischaemic stroke were 1.33 (1.01-1.75), 1.57 (1.17-2.10) and 1.95 (1.34-2.82) in TyG quartile (Q) 2, 3 and 4 groups, respectively, compared with Q1. A significant interaction between TyG index and age for risk of ischaemic stroke (P < 0.001) was also observed. However, no significant interaction was found between TyG index and other potential risk factors of risk for ischaemic stroke, although there were significant positive associations with female, non-smoker, non-drinker, low or moderate physical activity, non-obese and non-type 2 diabetes mellitus groups.
Elevated TyG index is an independent predictor of ischaemic stroke in the general population, and insulin resistance may be positively associated with future stroke risk.
由于胰岛素抵抗与缺血性卒中之间的关联存在争议，我们的研究旨在探讨甘油三酯-葡萄糖（TyG）这一胰岛素抵抗的替代标志物与缺血性卒中事件的相关性，并进一步评估几种已知卒中危险因素对其的潜在影响。
农村中国队列研究纳入了 11777 名年龄≥40 岁的参与者，他们在 2007-2008 年基线时无卒中及心血管疾病史，并在 2013-2014 年期间进行随访。TyG 采用以下公式计算：Ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]。采用校正泊松回归模型估计与 TyG 相关的缺血性卒中事件的相对风险（RR）和 95%置信区间（CI）。
在中位随访 6 年期间，共确定了 677 例新发缺血性卒中病例。经多变量校正后，TyG 四分位组（Q）2、3 和 4 组发生缺血性卒中的 RR（95%CI）值分别为 1.33（1.01-1.75）、1.57（1.17-2.10）和 1.95（1.34-2.82），与 Q1 组相比。TyG 指数与年龄对缺血性卒中风险的交互作用也具有统计学意义（P<0.001）。然而，TyG 指数与其他缺血性卒中危险因素之间的交互作用并不显著，尽管与女性、非吸烟者、非饮酒者、低或中强度体力活动者、非肥胖者和非 2 型糖尿病患者群体呈显著正相关。
升高的 TyG 指数是一般人群发生缺血性卒中的独立预测因子，胰岛素抵抗可能与未来卒中风险呈正相关。
