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 in | Nutrition, metabolism, and cardiovascular diseases Vol. 30; no. 2; pp. 245 - 253 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Netherlands
Elsevier B.V
10.02.2020
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Online Access | Get full text |
ISSN | 0939-4753 1590-3729 1590-3729 |
DOI | 10.1016/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. |
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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 |
Author_xml | – sequence: 1 givenname: Wenrui surname: Shi fullname: Shi, Wenrui organization: Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China – sequence: 2 givenname: Liying surname: Xing fullname: Xing, Liying organization: Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China – sequence: 3 givenname: Li surname: Jing fullname: Jing, Li organization: Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China – sequence: 4 givenname: Yuanmeng surname: Tian fullname: Tian, Yuanmeng organization: Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China – sequence: 5 givenname: Han surname: Yan fullname: Yan, Han organization: Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, People's Republic of China – sequence: 6 givenname: Qun surname: Sun fullname: Sun, Qun organization: Disease Control and Prevention of Chao Yang City, Chaoyang, Liaoning, People's Republic of China – sequence: 7 givenname: Dong surname: Dai fullname: Dai, Dong organization: Disease Control and Prevention of Dan Dong City, Dandong, Liaoning, People's Republic of China – sequence: 8 givenname: Lei surname: Shi fullname: Shi, Lei organization: Disease Control and Prevention of Liao Yang City, Liaoyang, Liaoning, People's Republic of China – sequence: 9 givenname: Shuang 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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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. |
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Keywords | Triglyceride-glucose index Insulin resistance Hyperglycemia Ischemic stroke Dyslipidemia |
Language | English |
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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 |
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