Bian Keyu, Hou Chao, Jin Huafeng, Feng Xiaoli, Peng Min, Zhao Xingqi, Yuan Xiangling, Sun Wen, Feng Haixing, Xu Gelin
Department of Neurology, Wujin TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, Jiangsu 213100, China; Department of Neurology, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China.
Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China.
Diabetes Res Clin Pract. 2025 Apr;222:112064. doi: 10.1016/j.diabres.2025.112064. Epub 2025 Feb 24.
Triglyceride-glucose (TyG) related indices, including TyG, TyG-body mass index (TyG-BMI), and TyG-waist circumference (TyG-WC), have been identified as promising biomarkers for assessing insulin resistance (IR), a known risk factor for ischemic stroke. While previous research has highlighted the relevance of these indices in various metabolic disorders, their predictive utility for ischemic stroke across different glucose metabolic statuses has not been extensively explored.
This study utilized data from the UK Biobank, analyzing 392,733 participants free from ischemic stroke at baseline, categorized into normal glucose, prediabetes, and diabetes groups based on American Diabetes Association criteria. TyG-related indices were computed using baseline measures of fasting blood glucose and triglycerides. Participants were followed for a median of 14.68 years to assess the incidence of ischemic stroke. Cox proportional hazards models adjusted for demographic and clinical covariates were used to explore the associations between TyG indices and stroke risk.
Over the follow-up period, 8033 participants experienced an ischemic stroke. Higher TyG-related indices were associated with an increased stroke risk in all glucose metabolism groups, with the strongest associations observed in the prediabetes and normal glucose groups. The risk of stroke increased progressively across quartiles of TyG, TyG-BMI, and TyG-WC indices. The analysis revealed that each unit increase in the TyG index significantly elevated stroke risk in diabetic individuals, while TyG-BMI and TyG-WC indices showed significant predictive power in the prediabetes and normal glucose groups.
TyG-related indices, particularly TyG-BMI and TyG-WC, are effective in predicting the risk of ischemic stroke, especially among individuals with prediabetes and normal glucose levels. These findings underscore the utility of TyG indices as tools for early detection and preventive strategies in stroke risk management across various states of glucose metabolism.
甘油三酯-葡萄糖(TyG)相关指标,包括TyG、TyG体重指数(TyG-BMI)和TyG腰围(TyG-WC),已被确定为评估胰岛素抵抗(IR)的有前景的生物标志物,胰岛素抵抗是缺血性中风的已知危险因素。虽然先前的研究强调了这些指标在各种代谢紊乱中的相关性,但它们在不同葡萄糖代谢状态下对缺血性中风的预测效用尚未得到广泛探索。
本研究利用英国生物银行的数据,分析了392733名基线时无缺血性中风的参与者,根据美国糖尿病协会标准将其分为正常血糖、糖尿病前期和糖尿病组。使用空腹血糖和甘油三酯的基线测量值计算TyG相关指标。对参与者进行了中位数为14.68年的随访,以评估缺血性中风的发生率。采用调整了人口统计学和临床协变量的Cox比例风险模型来探讨TyG指标与中风风险之间的关联。
在随访期间,8033名参与者发生了缺血性中风。在所有葡萄糖代谢组中,较高的TyG相关指标与中风风险增加相关,在糖尿病前期和正常血糖组中观察到的关联最强。中风风险随着TyG、TyG-BMI和TyG-WC指标的四分位数逐渐增加。分析显示,TyG指数每增加一个单位,糖尿病个体的中风风险显著升高,而TyG-BMI和TyG-WC指标在糖尿病前期和正常血糖组中显示出显著的预测能力。
TyG相关指标,特别是TyG-BMI和TyG-WC,在预测缺血性中风风险方面是有效的,尤其是在糖尿病前期和血糖水平正常的个体中。这些发现强调了TyG指标作为在各种葡萄糖代谢状态下中风风险管理中早期检测和预防策略工具的效用。