Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
College of Anesthesiology, Shanxi Medical University, Taiyuan, China.
Front Endocrinol (Lausanne). 2024 Oct 17;15:1444030. doi: 10.3389/fendo.2024.1444030. eCollection 2024.
The Triglyceride-Glucose (TyG) index, an indicator of insulin resistance, has been proposed as a predictor of cardiovascular diseases. However, its role in predicting stroke risk, particularly in low-income populations, is not well understood. This study aimed to investigate the predictive value of the TyG index for stroke incidence in a low-income Chinese population, with a focus on gender and age-specific differences.
This 10-year prospective cohort study included 3,534 participants aged ≥45 years from rural areas in northern China. Baseline data on demographic characteristics, lifestyle factors, and clinical measurements were collected. Participants were followed for stroke incidence, categorized into ischemic and hemorrhagic stroke. Multivariate logistic regression models were used to assess the association between the TyG index and stroke incidence, adjusting for potential confounders.
During the follow-up period, 368 participants (10.4%) experienced a stroke, with 327 ischemic and 31 hemorrhagic strokes. TyG index was significantly associated with total and ischemic stroke incidence but not hemorrhagic stroke. After adjusting for confounding factors, for every one standard deviation increase in TyG index, the risk of stroke increased by 32% for overall stroke (RR: 1.32; 95% CI: 1.08-1.61; P=0.006) and 39% for ischemic stroke (RR: 1.39; 95% CI: 1.12-1.73; P=0.003). The risk of stroke in the highest TyG tertile levels (tertile 3) increased by 49% (RR: 1.49; 95% CI 1.11-1.99; P=0.007) for overall stroke, compared to those in the lowest tertile levels (tertile 1). For ischemic stroke, the risk of stroke increased by 53% (RR: 1.53; 95% CI 1.12-2.11; P=0.008) in the highest TyG tertile levels (tertile 3) compared to those in the lowest tertile levels (tertile 1).
This 10-year prospective cohort study has established the TyG index as an independent predictor of both total and ischemic stroke incidence in a low-income Chinese population. The findings indicate that the TyG index is particularly effective in predicting stroke risk among women and older adults (≥60 years), but not for hemorrhagic stroke. These insights are crucial for improving clinical practice and stroke prevention strategies.
甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的指标，已被提出作为心血管疾病的预测因子。然而，其在预测中风风险方面的作用，特别是在低收入人群中，尚不清楚。本研究旨在探讨 TyG 指数在预测中国低收入人群中风发生率方面的预测价值，并特别关注性别和年龄特异性差异。
这是一项为期 10 年的前瞻性队列研究，纳入了来自中国北方农村地区的 3534 名年龄≥45 岁的参与者。收集了人口统计学特征、生活方式因素和临床测量的基线数据。随访中风发病率，分为缺血性和出血性中风。使用多变量逻辑回归模型评估 TyG 指数与中风发病率之间的关联，调整了潜在的混杂因素。
在随访期间，368 名参与者（10.4%）发生了中风，其中 327 例为缺血性中风，31 例为出血性中风。TyG 指数与总中风和缺血性中风发生率显著相关，但与出血性中风无关。在调整混杂因素后，TyG 指数每增加一个标准差，中风的总体风险增加 32%（RR：1.32；95%CI：1.08-1.61；P=0.006），缺血性中风的风险增加 39%（RR：1.39；95%CI：1.12-1.73；P=0.003）。最高 TyG 三分位水平（三分位 3）的中风风险比最低三分位水平（三分位 1）增加了 49%（RR：1.49；95%CI 1.11-1.99；P=0.007），而总体中风的风险则增加了 53%（RR：1.53；95%CI 1.12-2.11；P=0.008）。
这项为期 10 年的前瞻性队列研究确立了 TyG 指数是中国低收入人群总中风和缺血性中风发生率的独立预测因子。研究结果表明，TyG 指数特别适用于预测女性和老年人（≥60 岁）的中风风险，但不适用于出血性中风。这些发现对于改善临床实践和中风预防策略至关重要。
