Department of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University.
Institute of Geriatrics, Jiangxi Provincial People's Hospital and The First Affiliated Hospital of Nanchang Medical College.
Int J Surg. 2024 Sep 1;110(9):5409-5416. doi: 10.1097/JS9.0000000000001795.
The triglyceride glucose index (TyG) is associated with cardiovascular diseases; however, its association with stroke remains unclear. This study aimed to elucidate this relationship by examining two extensive cohort studies using two-sample Mendelian randomization (MR).
Using data from the 1999-2018 National Health and Nutrition Examination Survey (NHANES) and the Medical Information Mart for Intensive Care (MIMIC)-IV, the correlation between TyG (continuous and quartile) and stroke was examined using multivariate Cox regression models and sensitivity analyses. Two-sample MR was employed to establish causality between TyG and stroke using the inverse variance weighting method. Genome-wide association study catalog queries were performed for single nucleotide polymorphism-mapped genes, and the STRING platform used to assess protein interactions. Functional annotation and enrichment analyses were also conducted.
From the NHANES and MIMIC-IV cohorts, we included 740 and 589 participants with stroke, respectively. After adjusting for covariates, TyG was linearly associated with the risk of stroke death (NHANES: hazard ratio [HR] 0.64, 95% CI: 0.41-0.99, P =0.047; Q3 vs. Q1, HR 0.62, 95% CI: 0.40-0.96, P =0.033; MIMIC-IV: HR 0.46, 95% CI: 0.27-0.80, P =0.006; Q3 vs. Q1, HR 0.32, 95% CI: 0.12-0.86; Q4 vs. Q1, HR 0.30, 95% CI: 0.10-0.89, P =0.030, P for trend=0.017). Two-sample MR analysis showed genetic prediction supported a causal association between a higher TyG and a reduced risk of stroke (odds ratio 0.711, 95% CI: 0.641-0.788, P =7.64e -11 ).
TyG was causally associated with a reduced risk of stroke. TyG is a critical factor for stroke risk management.
甘油三酯-葡萄糖指数（TyG）与心血管疾病相关，但与中风的关系尚不清楚。本研究旨在通过两样本孟德尔随机化（MR）检验，使用两个大型队列研究来阐明这种关系。
使用 1999-2018 年全国健康与营养调查（NHANES）和医疗信息集市重症监护（MIMIC）-IV 的数据，使用多变量 Cox 回归模型和敏感性分析，检查 TyG（连续和四分位数）与中风之间的相关性。使用逆方差加权法进行两样本 MR，以确定 TyG 与中风之间的因果关系。对单核苷酸多态性映射基因进行全基因组关联研究目录查询，并使用 STRING 平台评估蛋白质相互作用。还进行了功能注释和富集分析。
从 NHANES 和 MIMIC-IV 队列中，我们分别纳入了 740 名和 589 名中风患者。调整协变量后，TyG 与中风死亡风险呈线性相关（NHANES：风险比 [HR]0.64，95%置信区间：0.41-0.99，P=0.047；Q3 与 Q1 相比，HR0.62，95%置信区间：0.40-0.96，P=0.033；MIMIC-IV：HR0.46，95%置信区间：0.27-0.80，P=0.006；Q3 与 Q1 相比，HR0.32，95%置信区间：0.12-0.86；Q4 与 Q1 相比，HR0.30，95%置信区间：0.10-0.89，P=0.030，P 趋势=0.017）。两样本 MR 分析表明，遗传预测支持 TyG 升高与中风风险降低之间存在因果关系（比值比 0.711，95%置信区间：0.641-0.788，P=7.64e-11）。
TyG 与中风风险降低有因果关系。TyG 是中风风险管理的关键因素。
