Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study

Huang, Zegui; Ding, Xiong; Yue, Qing; Wang, Xianxuan; Chen, Zekai; Cai, Zefeng; Li, Weijian; Cai, Zhiwei; Lan, Yulong; Wu, Weiqiang; Wu, Shouling; Chen, Youren

doi:10.1186/s12933-022-01577-7

Cited by 48 publications

(42 citation statements)

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“…It was recently noted that the variability and longitudinal trajectory in the TyG-index, both regarded as novel and important indicators for outcome events, had strong predictive effects for cardiovascular diseases [35][36][37][38]. With either variability or longitudinal trajectory in the TyG-index, the effects on CMDs risk in this research are consistent with a previous study that found those indicators (variability and trajectory) to be associated with CMDs risk.…”

Section: Discussionsupporting

confidence: 87%

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

Zhao

Gao

et al. 2022

Preprint

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Background The triglyceride-glucose (TyG) index is considered as a pivotal factor for various metabolic, cardiovascular, and cerebrovascular diseases. However, there is currently a paucity of relevant studies on the association between long-term level and change of TyG-index and cardiometabolic diseases (CMDs) risk.We aimed to explore the risk of CMDs in relation to the long-term level and change of TyG-index. Methods Based on the prospective cohort study, a total of 36359 subjects who were free of CMDs, had complete data of triglyceride (TG) and fasting blood glucose (FBG) and underwent four health check-ups from 2006 to 2012 consecutively were followed up for CMDs until 2021. The associations between long-term level and change of TyG-index and CMDs risk were assessed by Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). The TyG-index was calculated as ln [TG, mg/dL) × FBG, mg/dL)/2]. Results During the median observation period of 8 years, 4685 subjects were newly diagnosed with CMDs. In multivariable-adjusted models, a graded positive association was observed between CMDs and long-term TyG-index. Compared with the Q1 group, subjects with the Q2-Q4 group had increased progressively risk of CMDs, with corresponding HRs of 1.64(1.47–1.83), 2.36(2.13–2.62), 3.15(2.84–3.49), respectively. The association was marginally attenuated, after further adjustment for the baseline TyG level. In addition, compared with stable TyG level, both loss and gain in TyG level were associated with increased CMDs risk. Conclusions Long-term elevated level and change of TyG-index are risk factors for the incident CMDs. Elevated TyG-index in the early stage remains to exert cumulative effects on the occurrence of CMDs even after accounting for the baseline TyG-index.

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Section: Discussionsupporting

confidence: 87%

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

Zhao

Gao

et al. 2022

Preprint

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“…A prospective study of 54,098 participants demonstrated that patients with higher TyG index experienced a 1.30-fold increased risk of IS [ 19 ]. Huang et al reported that long-term elevated TyG index in hypertensive patients was significantly associated with an increased risk of stroke, especially IS [ 20 ]. However, Zhao et al demonstrated a high TyG index was not associated with nondiabetic patients with non-ST-elevation myocardial infarctions [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis

Yang

Huang

Wang

et al. 2023

Cardiovasc Diabetol

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Background Strokes significantly impair quality of life and incur high economic and societal burdens. The triglyceride and glucose (TyG) index is a biochemical marker of insulin resistance (IR) and may have important value in the prediction of strokes, especially ischemic stroke (IS). Our study aims to investigate the relationship between TyG index and IS and ascertain whether TyG index is independently associated with IS adverse outcomes. Methods The Cochrane, Embase, Medline, Web of Science, PubMed, and other relevant English databases and related websites were systematically searched for articles on ‘‘TyG index’’ and "stroke" published from inception to April 4, 2022. We reviewed the available literature on the TyG index and its relation to predicting IS occurrence in the general population and adverse clinical outcomes. We calculated odds ratios (OR) of TyG index and its predictability of IS occurrence and adverse outcomes. Statistical analyses were performed using the Meta Package in STATA, version 12.0. Results A total of 18 studies and 592,635 patients were included in our analysis. The pooled effect values of all stroke types showed that higher TyG index was associated with increased the risk of IS in the general population (OR 1.37; 95% CI 1.22–1.54) in a total sample of 554,334 cases with a high level of heterogeneity (P = 0.000, I2 = 74.10%). In addition, compared to IS patients with a lower TyG index, IS patients with a higher TyG index was associated with higher risk of stroke recurrence (OR: 1.50; 95% CI 1.19–1.89) and increased risk of mortality (OR 1.40 95% CI 1.14–1.71). No correlation was found in the effect value combinations of poor functional outcomes (OR 1.12; 95% CI 0.88–1.43) and neurological worsening (OR: 1.76; 95% CI 0.79–3.95) in a total sample of 38,301 cases with a high level of heterogeneity (P = 0.000; I2 = 77.20%). Conclusions TyG index has potential value in optimizing risk stratification for IS in the general population. Furthermore, there is a significant association between high TyG index and many adverse outcomes of stroke, especially stroke recurrence and high mortality. Future studies should focus on multi-center and multi-regional designs in order to further explore the relationship between IS and TyG index.

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“…It was recently noted that the variability and longitudinal trajectory in the TyG-index, both regarded as novel and important indicators for outcome events, had strong predictive effects for cardiovascular diseases ( 39 – 42 ). With either variability or longitudinal trajectory in the TyG-index, the effects on CMDs risk in this research are consistent with a previous study that found those indicators (variability and trajectory) to be associated with CMDs risk.…”

Section: Discussionmentioning

confidence: 99%

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

Zhao

Gao

et al. 2023

Front. Endocrinol.

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ObjectiveThe triglyceride-glucose (TyG) index is considered as a pivotal factor for various metabolic, cardiovascular, and cerebrovascular diseases. However, there is currently a paucity of relevant studies on the association between long-term level and change of TyG-index and cardiometabolic diseases (CMDs) risk. We aimed to explore the risk of CMDs in relation to the long-term level and change of TyG-index.MethodsBased on the prospective cohort study, a total of 36359 subjects who were free of CMDs, had complete data of triglyceride (TG) and fasting blood glucose (FBG) and underwent four health check-ups from 2006 to 2012 consecutively were followed up for CMDs until 2021. The associations between long-term level and change of TyG-index and CMDs risk were assessed by Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). The TyG-index was calculated as ln [TG, mg/dL) × FBG, mg/dL)/2].ResultsDuring the median observation period of 8 years, 4685 subjects were newly diagnosed with CMDs. In multivariable-adjusted models, a graded positive association was observed between CMDs and long-term TyG-index. Compared with the Q1 group, subjects with the Q2-Q4 group had increased progressively risk of CMDs, with corresponding HRs of 1.64(1.47-1.83), 2.36(2.13-2.62), 3.15(2.84-3.49), respectively. The association was marginally attenuated, after further adjustment for the baseline TyG level. In addition, compared with stable TyG level, both loss and gain in TyG level were associated with increased CMDs risk.ConclusionsLong-term elevated level and change of TyG-index are risk factors for the incident CMDs. Elevated TyG-index in the early stage remains to exert cumulative effects on the occurrence of CMDs even after accounting for the baseline TyG-index.

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Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study

Cited by 48 publications

References 48 publications

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

The impact of triglyceride-glucose index on ischemic stroke: a systematic review and meta-analysis

Association of long-term triglyceride-glucose index level and change with the risk of cardiometabolic diseases

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