Association of triglyceride-glucose index with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion: a multicenter hospital-based prospective cohort study

Abstract

Background Triglyceride-glucose (TyG) index is a simple and reliable surrogate marker of insulin resistance. Elevated TyG index was related to stroke recurrence. This study aimed to explore the associations between TyG index with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion. Methods From November 1, 2016 to February 28, 2021, consecutive acute ischemic stroke patients admitted within 1 week after onset were screened. The stroke mechanism was determined based on medical history, laboratory examinations, cardiac examinations, vascular examinations and neuroimaging. Nondiabetic patients with small vessel occlusion were enrolled and followed up for 1 year. The primary outcome was ischemic stroke recurrence. Logistic regression and Kaplan–Meier survival curve were used to analyze the association of the TyG index and stroke recurrence. Results A total of 6100 acute ischemic stroke patients were screened, with 1970 nondiabetic patients with small vessel occlusion included and divided into 4 groups according to the TyG index quartiles (Q1: < 8.20; Q2: 8.20–8.53; Q3: 8.54–8.92; Q4: > 8.92). There were significant differences in age, body mass index, systolic blood pression, diastolic blood pressure, lipid-lowering agents, infarct location, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, and stroke recurrence among the 4 groups. In the multi-adjusted models, compared to Q1 of the TyG index, the odds ratio for Q4 of the TyG index for stroke recurrence was 3.100 (1.366–8.019). The Kaplan–Meier survival (ischemic stroke-free) curves by quartiles of the TyG index also showed statistically significant differences (log-rank test, P = 0.004). Conclusions Our findings suggested that the TyG index was associated with ischemic stroke recurrence in nondiabetic patients with small vessel occlusion, and it could be a valuable biomarker for assessing the risk of ischemic stroke recurrence in these patients.

Interacting and joint effects of triglyceride-glucose index (TyG) and body mass index on stroke risk and the mediating role of TyG in middle-aged and older Chinese adults: a nationwide prospective cohort study

“…In contrast to our initial hypothesis, our findings suggest that there is no significant synergy or interaction between these two factors in their impact on stroke risk. In essence, while both BMI and the TyG independently contribute to stroke risk [ 3 , 4 , 14 , 15 ], their combined effect does not appear to exceed the sum of their individual effects. This observation introduces complexity into our understanding of how BMI and the TyG jointly influence stroke risk.…”

“…Both BMI and TyG are individually associated with stroke [3,4,14,15], in addition, recent studies introduced a novel index called the triglyceride glucose-body mass index (TyG-BMI), and it has also been demonstrated to be associated with stroke [16][17][18]. However, the interplay between these two metrics remains largely unexplored.…”

The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke

“…Studies have evaluated the TGI in many areas, including its relationships with acute coronary syndrome in patients without [27][28][29][30][31][32][33] and with type 2 diabetes, [36] body mass index, [34,35] type 2 diabetes, [37][38][39][40][41] ischemic stroke, [41][42][43][44][45][46][47] cardiovascular disorders, [51][52][53] and intravenous thrombosis. [60,61] Like our study, some studies have examined the relationship between TGI and sarcopenia.…”

“…Therefore, they concluded that there was a strong relationship between TGI and acute coronary artery diseases. [27][28][29][30][31][32][33] In addition, the relationship between TGI and body mass index has been examined. [34,35] Moreover, TGI values have recently started to attract attention in patients with type 2 diabetes and acute coronary syndrome.…”

Triglyceride-glucose index as a biomarker to differentiate stroke subtypes: A hospital-based cross-sectional study

“…Several studies were carried out to understand the link between the TyG index and stroke subtypes. Zhang et al reported that the TyG index is correlated with SVD and may have the potential to optimize the risk stratification of SVD 13, 14 . Furthermore, the TyG index was reported to be a useful biomarker of LAA stroke and can help in identifying candidates for carotid reperfusion 15 .…”