Wu Man, Li Chaoyang, Yu Yiqing, Zeng Lijuan, Qiu Yufei, Liu Jiali, Yang Fen, Han Yangyang
Chengdu Third People's Hospital, Chengdu, China.
School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
Diabetol Metab Syndr. 2024 Jul 25;16(1):176. doi: 10.1186/s13098-024-01421-w.
Identifying high-risk populations and promoting stroke prevention measures can be achieved through studies on stroke and its risk factors. As a new alternative indicator of insulin resistance (IR), the triglyceride glucose (TyG) index may potentially increase stroke risk. However, the evidence confirming this association is inadequate and inconsistent, possibly due to variations in stroke assessment criteria or characteristics of the study populations. This study aims to evaluate the association between the TyG index and stroke risk level among individuals with normal-weight.
A total of 30,895 participants aged ≥ 40 years with normal-weight were enrolled in this study. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Normal-weight was described as a body mass index (BMI) of 18.5-<24.0 kg/m. Stroke risk was assessed by the Stroke Risk Assessment Scale, developed by the China National Stroke Screening and Prevention Project. To evaluate the associations between the TyG index and stroke risk level, multivariate logistic regression models were employed.
Results showed that when the TyG index was considered as a continuous variable, each one unit increase in the TyG index was associated with a significantly higher risk of stroke [Moderate-risk (OR, 2.15; 95% CI, 2.03-2.28; P<0.001); High-risk (OR, 3.83; 95% CI, 3.57-4.10; P<0.001)]. Compared with Q1 of the TyG index, Q4 was significantly associated with moderate stroke risk (OR, 2.73; 95% CI, 2.50-2.99; P<0.001) and high stroke risk (OR, 5.39; 95% CI, 4.83-6.01; P<0.001). The continuous TyG index was an important risk factor for high stroke risk in the metabolically obese, normal-weight (MONW) individuals (OR, 3.44;95% CI, 2.92-4.06; P < 0.001). In the MONW individuals, when Q1 was used as a reference, participants in Q4 (OR, 5.33; 95% CI, 4.19-6.78; P < 0.001) was significantly associated with high stroke risk. Subgroup analysis showed significant interaction in the age and sex subgroups in the overall population (P <0.001).
The risk of stroke is increased with the TyG index among Chinese adults of normal weight; hence, the index may be an important indicator for identifying high-risk stroke populations among individuals with normal body weight.
通过对中风及其危险因素的研究，可以确定高危人群并推广中风预防措施。作为胰岛素抵抗（IR）的一种新的替代指标，甘油三酯葡萄糖（TyG）指数可能会增加中风风险。然而，证实这种关联的证据并不充分且不一致，这可能是由于中风评估标准或研究人群特征的差异所致。本研究旨在评估正常体重个体中TyG指数与中风风险水平之间的关联。
本研究共纳入30895名年龄≥40岁的正常体重参与者。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]。正常体重定义为体重指数（BMI）为18.5-<24.0kg/m²。中风风险通过中国国家脑卒中筛查与预防项目制定的脑卒中风险评估量表进行评估。为了评估TyG指数与中风风险水平之间的关联，采用了多因素逻辑回归模型。
结果显示，当将TyG指数视为连续变量时，TyG指数每增加一个单位，中风风险显著升高[中度风险（OR，2.15；95%CI，2.03-2.28；P<0.001）；高度风险（OR，3.83；95%CI，3.57-4.10；P<0.001）]。与TyG指数的第一四分位数相比，第四四分位数与中度中风风险（OR，2.73；95%CI，2.50-2.99；P<0.001）和高度中风风险（OR，5.39；95%CI，4.83-6.01；P<0.001）显著相关。连续的TyG指数是代谢性肥胖正常体重（MONW）个体中高中风风险的重要危险因素（OR，3.44；95%CI，2.92-4.06；P<0.001）。在MONW个体中，以第一四分位数为参照，第四四分位数的参与者（OR，5.33；95%CI，4.19-6.78；P<0.001）与高中风风险显著相关。亚组分析显示总体人群中年龄和性别亚组存在显著交互作用（P<0.001）。
正常体重的中国成年人中，中风风险随TyG指数升高而增加；因此，该指数可能是识别正常体重个体中高危中风人群的重要指标。
