Comparison of six surrogate insulin resistance indexes for predicting the risk of incident stroke: The Rural Chinese Cohort Study

Abstract

Background and Purpose: Some cheap and easily used operated indexes of insulin resistance (IR) were currently available. We aimed to evaluate the association of six surrogate indexes of IR with incident stroke and to compare their predictive capacity. Methods:We analysed data from 14,595 eligible study participants from the Rural Chinese Cohort Study. Modified Poisson regression models were used to estimate relative risks (RRs) and 95% confidence intervals (95% CIs) of incident stroke associated with the visceral adiposity index (VAI), the Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), triglyceride-glucose (TyG), TyGbody mass index, and TyG-waist circumference. The receiver operator characteristic curve was used to compare the ability of the abovementioned IR indexes to predict stroke.Results: During a median follow-up of 6 years, 786 newly diagnosed stroke cases were identified. The levels of six surrogate indexes of IR were all significantly higher in the stroke population than in the non-stroke population (p < 0.001). Compared with quartile 1, the multivariable adjusted RRs (95% CIs) of incident stroke for quartile 4 were 2.01 (1.47-2.76), 1.62 (1.28, 2.04), 1.64 (1.28-2.09), and 1.92 (1.50-2.45) for CVAI, VAI, LAP, and TyG, respectively. Significant dose-response associations were also found between surrogate IR indexes and risk of stroke. The area under the curves|areas under the curves for CVAI (0.674) was significantly greater than for other indexes (TyG-WC:0.622, TyG:0.614, LAP:0.606, TyG-BMI:0.598, and VAI:0.577) (p < 0.001).Conclusions: Six surrogate indexes of IR were independently associated with incident stroke. The CVAI may be the most suitable index for stroke prediction.

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

“…Many previous studies have shown an association between a higher TyG index and an increased incidence of atherosclerosis, intima media thickness of common carotid artery, unstable carotid plaque, hypertension, arterial stiffness, and cardiovascular disease [10][11][12][13]. As expected, a plenty of evidences proved that TyG index was independently associated with the occurrence of stroke, and a higher TyG index was also a predictor of all-cause mortality and poor outcomes in patients with acute ischemic stroke [14][15][16][17].…”

Dose–response association between Chinese visceral adiposity index and cardiovascular disease: a national prospective cohort study

“…Consistent with our findings, Zhao et al. found CVAI associated with stroke based on rural population of a Chinese county ( 17 ). We additionally found linear association between CVAI and stroke using national data, which was in line with Zhang et al.…”

“…However, whether CVAI also predict incident CVD well among general population remains unclear. Studies based on rural population from a Chinese county or health examination population in a Beijing hospital reported positive associations between CVAI and stroke or coronary heart disease ( 17 , 18 ), respectively. Another study from a Chinese province showed that CVAI was positively associated with CVD in women but not in men ( 19 ).…”

Assessment of six surrogate insulin resistance indexes for predicting cardiometabolic multimorbidity incidence in Chinese middle‐aged and older populations: Insights from the China health and retirement longitudinal study

“…For example, Zhao et al have revealed independent associations between multiple IR surrogates and stroke incidence data from a rural Chinese cohort study, with CVAI identified as the most suitable predictor of stroke. 30 Another study has reported a strong association between CVAI and the risk of coronary heart disease, surpassing VAI in predicting risk among Asian populations. 31 Consistent with previous research, our analysis revealed that CVAI was the most accurate predictor of CMM, followed by Obesity increases the risk of cardiovascular metabolic diseases.…”

“…For example, Zhao et al. have revealed independent associations between multiple IR surrogates and stroke incidence data from a rural Chinese cohort study, with CVAI identified as the most suitable predictor of stroke 30 . Another study has reported a strong association between CVAI and the risk of coronary heart disease, surpassing VAI in predicting risk among Asian populations 31 .…”