Triglyceride-glucose index and the incidence of stroke: A meta-analysis of cohort studies

Abstract

BackgroundInsulin resistance (IR) is involved in the pathogenesis of atherosclerosis. As a new indicator, the triglyceride-glucose (TyG) index has greater operability for the evaluation of insulin resistance. Previous studies have shown inconsistent results in evaluating the association between the TyG index and stroke incidence in people without stroke at baseline. Therefore, this study aimed to systematically assess this association through a meta-analysis.MethodsCohort studies with the multivariate-adjusted hazard ratio (HR) association between the TyG index and stroke were obtained by searching the PubMed, Cochrane Library, and EMBASE databases before 16 December 2021. We pooled the adjusted HR along with 95% CI using a random-effects model. The primary outcome was stroke including ischemic and hemorrhagic stroke. We conducted subgroup analyses stratified by study design, ethnicity, characteristics of participants, weight of studies, and length of follow-up duration. Review Manager 5.3 and Stata 17 were used to perform the meta-analysis.ResultsEight cohort studies with 5,804,215 participants were included. The results showed that participants with the highest TyG index category at baseline compared to those with the lowest TyG index category were independently associated with a higher risk of stroke (HR: 1.26, 95% CI: 1.24–1.29, I2 = 0%, P < 0.001). This finding was consistent with the results of the meta-analysis with the TyG index analyzed as a continuous variable (HR per each-unit increment of the TyG index: 1.13, 95% CI 1.09–1.18, I2 = 0%, P < 0.001). Subgroup analysis had no significant effects (for subgroup analysis, all P > 0.05). No significant heterogeneity was observed among the included cohort studies.ConclusionA higher TyG index may be independently associated with a higher risk of stroke in individuals without stroke at baseline. The aforementioned findings need to be verified by a large-scale prospective cohort study to further clarify the underlying pathophysiological mechanism between the TyG index and stroke.

The association between triglyceride-glucose index and its combination with obesity indicators and stroke: CHARLS 2011-2020

“…Our study elucidated a significant and positive association between TyG and stroke prevalence in the Chinese population, corroborating the findings of previous investigations [35,36]. However, most of the existing studies on the relationship between TyG and stroke have focused on small sample cohorts in different countries with relatively few studies conducted in large sample background [37]. Thus, our study filled this knowledge gap and enhanced the understanding of the universality of this relationship.…”

Association between triglyceride glucose index and all-cause mortality in patients with cerebrovascular disease: a retrospective study

“…Despite the wealth of literature on the association between TyG index and ischemic stroke [ 39 , 40 ], atherosclerosis [ 41 ], and coronary syndromes [ 42 ], scant attention has been paid to its connection with CVDs. Our study bridges this gap by establishing a linear association between the TyG index and 28- and 90-day mortality due to CVD.…”

Triglyceride glucose index as a predictor of mortality in middle-aged and elderly patients with type 2 diabetes in the US

“…The combined variables of glucose and triglycerides make the TyG index closely associated with related metabolic diseases. Several recent studies have shown that the TyG index improves the prognosis of CVD 35 – 38 . Similarly, the TyG index's prognostic utility for diabetic patients has been the subject of extensive research.…”