Wang Mengdie, Gao Bing, Huang Fei
Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China.
Cardiovasc Diabetol. 2025 Mar 12;24(1):119. doi: 10.1186/s12933-025-02668-x.
Numerous studies have investigated the effect of an integrated index that combines the triglyceride‒glucose (TyG) index with various obesity indicators on stroke incidence. However, how to use the TyG index and the Chinese Visceral Adiposity Index (CVAI) for stroke prevention remains unclear. This study examined the associations between dynamic changes in the TyG-CVAI index and cumulative, baseline, and new-onset stroke risk.
Data from 3,769 participants in the China Health and Retirement Longitudinal Study(CHARLS) were analyzed, concentrating on the baseline TyG-CVAI, TyG-CVAI in 2015, and the cumulative TyG-CVAI derived from these. The fluctuations of the TyG-CVAI index were grouped into three clusters using K-means clustering analysis. Logistic regression models were used to examine the relationship between the TyG-CVAI index and new-onset stroke risk. Restricted cubic splines (RCS) were employed to investigate potential nonlinear relationships while assessing the predictive capability by receiver operating characteristic curve.
During the follow-up period, 181 participants experienced stroke events. The stroke incidence rates in Clusters 1, 2, and 3 were 2.42%, 8.72%, and 4.37%, respectively. After adjustment for confounding factors, Cluster 2 with high and increasing TyG-CVAI index (OR = 3.16, 95% CI 1.94-5.22), the Q3 group with high cumulative TyG-CVAI index (OR = 2.53, 95% CI 1.60-4.02), and the Q3 group with high baseline TyG-CVAI index (OR = 2.49, 95% CI 1.57-3.95),which were all correlated with an elevated risk of new-onset stroke. The RCS analysis disclosed a U-shaped relationship between cumulative and baseline TyG-CVAI index and stroke risk.
The fluctuations in and baseline, and cumulative TyG-CVAI index are independently correlated with an increased risk of stroke. The TyG-CVAI index is anticipated to be a more efficient and significant indicator for evaluating early stroke.
众多研究探讨了将甘油三酯-葡萄糖（TyG）指数与各种肥胖指标相结合的综合指数对中风发病率的影响。然而，如何利用TyG指数和中国内脏脂肪指数（CVAI）预防中风仍不清楚。本研究考察了TyG-CVAI指数的动态变化与累积性、基线及新发中风风险之间的关联。
对中国健康与养老追踪调查（CHARLS）中3769名参与者的数据进行分析，重点关注基线TyG-CVAI、2015年的TyG-CVAI以及由此得出的累积TyG-CVAI。采用K均值聚类分析将TyG-CVAI指数的波动分为三类。使用逻辑回归模型检验TyG-CVAI指数与新发中风风险之间的关系。采用限制性立方样条（RCS）研究潜在的非线性关系，同时通过受试者工作特征曲线评估预测能力。
在随访期间，181名参与者发生了中风事件。第1、2、3组的中风发病率分别为2.42%、8.72%和4.37%。在对混杂因素进行调整后，TyG-CVAI指数高且呈上升趋势的第2组（比值比[OR]=3.16，95%置信区间[CI]1.94-5.22）、累积TyG-CVAI指数高的第3四分位数组（OR=2.53，95%CI 1.60-4.02）以及基线TyG-CVAI指数高的第3四分位数组（OR=2.49，95%CI 1.57-3.95），均与新发中风风险升高相关。RCS分析揭示了累积和基线TyG-CVAI指数与中风风险之间呈U形关系。
TyG-CVAI指数的波动、基线及累积指数均与中风风险增加独立相关。TyG-CVAI指数有望成为评估早期中风更有效且重要的指标。
