Lu Lifei, Chen Yubiao, Liu Baiyun, Li Xicong, Wang Jiale, Nie Zhengchang, Fu Xiaodong
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, People's Republic of China.
Guangzhou National Laboratory, Guangzhou, People's Republic of China.
Cardiovasc Diabetol. 2025 May 12;24(1):202. doi: 10.1186/s12933-025-02754-0.
The triglyceride-glucose (TyG) index was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0-3. However, the relationship between cumulative of TyG (cumTyG) and incidence of stroke remains unclear in individuals with CKM syndrome stages 0-3.
Participants with CKM syndrome stage 0-3 were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. TyG was calculated as ln [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)/2], and the cumTyG, as an area-under-the-curve estimate (mean TyG × time span), was calculated as (TyG + TyG )/2 * time . TyG control levels were classified using k-mean clustering analysis. Logistic regression was used to analyze the effect of cumTyG and TyG control levels on the incidence of stroke. Restricted cubic spline models (RCS) were performed to explore the potential non-linear relationship between cumTyG and stroke risk at different CKM syndrome stages 0-3.
A total of 4,700 CKM syndrome stages 0-3 participants were enrolled, among 280 patients had developed stroke during the 3-year follow-up period. After adjusting for confounders, compared to class 1 group, the odds ratio (OR) of incidents of stroke for class 2 was 1.39 [95% confidence interval (CI) 1.003, 1.92], P = 0.046; the OR of incidents of stroke for class 3 was 1.28 (95% CI 0.92-1.77), P = 0.147, the OR of incidents of stroke for class 4 was 1.28 (95% CI 0.84-1.94), P = 0.238. Elevated cumTyG was associated with an increase in incidence of stroke (OR 1.13, 95% CI 1.05, 1.22, P = 0.002). The relationship between the cumTyG index and stroke was linear in restricted cubic spline regression.
Elevated cumTyG was associated with an increased risk of stroke events in the population of CKM syndrome stages 0-3. Long-term dynamic monitoring of changes of TyG may help in the early identification of patients at high risk of developing stroke in the individuals with CKM syndrome stages 0-3.
甘油三酯-葡萄糖（TyG）指数与心血管-肾脏-代谢（CKM）综合征0-3期个体的较高死亡风险相关。然而，在CKM综合征0-3期个体中，累积TyG（cumTyG）与中风发病率之间的关系仍不明确。
从2011年至2015年的中国健康与养老追踪调查（CHARLS）中纳入CKM综合征0-3期的参与者。TyG计算公式为ln[空腹甘油三酯（mg/dL）×空腹血糖（mg/dL）/2]，cumTyG作为曲线下面积估计值（平均TyG×时间跨度），计算公式为（TyG₁ + TyG₂）/2×时间。使用k均值聚类分析对TyG控制水平进行分类。采用逻辑回归分析cumTyG和TyG控制水平对中风发病率的影响。进行受限立方样条模型（RCS）以探讨在不同CKM综合征0-3期cumTyG与中风风险之间潜在的非线性关系。
共纳入4700名CKM综合征0-3期参与者，其中280名患者在3年随访期内发生中风。在调整混杂因素后，与1类组相比，2类组中风事件的比值比（OR）为1.39[95%置信区间（CI）1.003，1.92]，P = 0.046；3类组中风事件的OR为1.28（95%CI 0.92 - 1.77），P = 0.147，4类组中风事件的OR为1.28（95%CI 0.84 - 1.94），P = 0.238。cumTyG升高与中风发病率增加相关（OR 1.13，95%CI 1.05，1.22，P = 0.002）。在受限立方样条回归中，cumTyG指数与中风之间的关系呈线性。
cumTyG升高与CKM综合征0-3期人群中风事件风险增加相关。对TyG变化进行长期动态监测可能有助于早期识别CKM综合征0-3期个体中发生中风的高危患者。
