Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population

Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent...

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Published inNutrition, metabolism, and cardiovascular diseases Vol. 30; no. 2; pp. 245 - 253
Main Authors Shi, Wenrui, Xing, Liying, Jing, Li, Tian, Yuanmeng, Yan, Han, Sun, Qun, Dai, Dong, Shi, Lei, Liu, Shuang
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 10.02.2020
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ISSN0939-4753
1590-3729
1590-3729
DOI10.1016/j.numecd.2019.09.015

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Abstract Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke. This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112–0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001–0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk. The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population. •TyG index closely correlated with the prevalent ischemic stroke.•TyG may serve as a linear indicator for the presence of ischemic stroke.•TyG may have its potential to optimize the risk stratification of ischemic stroke.
AbstractList Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke.This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112–0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001–0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk.The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.
Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke. This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112–0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001–0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk. The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population. •TyG index closely correlated with the prevalent ischemic stroke.•TyG may serve as a linear indicator for the presence of ischemic stroke.•TyG may have its potential to optimize the risk stratification of ischemic stroke.
Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke. This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112-0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001-0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk. The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.
Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke.BACKGROUND AND AIMSRecent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin resistance contributes to ischemic stroke via multiple mechanisms. Our study aimed to investigate the association between TyG and prevalent ischemic stroke, exploring the value of TyG to optimize the risk stratification of ischemic stroke.This cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112-0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001-0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk.METHODS AND RESULTSThis cross-sectional study included 10,900 subjects (mean age: 59.95 years, 59.8% females) from rural areas of northeast China between September 2017 to May 2018. TyG was calculated as ln[fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The prevalence of ischemic stroke was 5.49%. After adjusting for all covariates, each SD increment of TyG caused 22.8% additional risk for ischemic stroke. When dividing TyG into quartiles, the top quartile had a 1.776 times risk for ischemic stroke against the bottom category. Furthermore, smoothing curve fitting demonstrated this association was linear in the whole range of TyG. Finally, AUC revealed an improvement when introducing TyG into clinical risk factors (0.746 vs 0.751, p = 0.029). Consistently, category-free net reclassification index (0.195, 95% CI: 0.112-0.277, P < 0.001) and integrated discrimination index (0.003, 95% CI: 0.001-0.004, P < 0.001) confirmed the improvement by TyG to stratify ischemic stroke risk.The prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.CONCLUSIONThe prevent ischemic stroke correlated proportionally with the increment of TyG, implicating the linearity of TyG as an indicator of ischemic stroke. Our findings suggest the potential value of TyG to optimize the risk stratification of ischemic stroke in a general population.
Author Sun, Qun
Dai, Dong
Jing, Li
Xing, Liying
Shi, Lei
Tian, Yuanmeng
Yan, Han
Liu, Shuang
Shi, Wenrui
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  surname: Shi
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  organization: Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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  surname: Jing
  fullname: Jing, Li
  organization: Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
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  fullname: Tian, Yuanmeng
  organization: Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China
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  organization: Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, People's Republic of China
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  fullname: Dai, Dong
  organization: Disease Control and Prevention of Dan Dong City, Dandong, Liaoning, People's Republic of China
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  surname: Liu
  fullname: Liu, Shuang
  email: Shuangliu_cmu1h@163.com
  organization: Department of Cardiovascular Ultrasound, The First Affiliated Hospital of China Medical University, Shenyang, 110005, Liaoning, People's Republic of China
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31744716$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
Copyright_xml – notice: 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
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Issue 2
Keywords Triglyceride-glucose index
Insulin resistance
Hyperglycemia
Ischemic stroke
Dyslipidemia
Language English
License Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
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PublicationDate_xml – month: 02
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  text: 2020-02-10
  day: 10
PublicationDecade 2020
PublicationPlace Netherlands
PublicationPlace_xml – name: Netherlands
PublicationTitle Nutrition, metabolism, and cardiovascular diseases
PublicationTitleAlternate Nutr Metab Cardiovasc Dis
PublicationYear 2020
Publisher Elsevier B.V
Publisher_xml – name: Elsevier B.V
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Snippet Recent studies have recognized triglyceride-glucose index (TyG) as a practical surrogate of insulin resistance. Previous studies have demonstrated that insulin...
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SubjectTerms blood glucose
China
cross-sectional studies
Dyslipidemia
fasting
females
Hyperglycemia
Insulin resistance
Ischemic stroke
risk assessment
risk factors
rural areas
stroke
triacylglycerols
Triglyceride-glucose index
Title Value of triglyceride-glucose index for the estimation of ischemic stroke risk: Insights from a general population
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0939475319303540
https://dx.doi.org/10.1016/j.numecd.2019.09.015
https://www.ncbi.nlm.nih.gov/pubmed/31744716
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Volume 30
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