Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study
Abstract Objective Various modified triglyceride and glucose (TyG) indices have been proposed, but the literature on the impact and ability of the modified TyG index to predict stroke disease remains limited. We aimed to investigate the associations between the modified TyG indices and incident stro...
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BMC
2025-07-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02827-0 |
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| author | Jiaan Sun Xianglong Meng Lichun Guo Chongwen Nian Haina Li Wanxin Huang |
| author_facet | Jiaan Sun Xianglong Meng Lichun Guo Chongwen Nian Haina Li Wanxin Huang |
| author_sort | Jiaan Sun |
| collection | DOAJ |
| description | Abstract Objective Various modified triglyceride and glucose (TyG) indices have been proposed, but the literature on the impact and ability of the modified TyG index to predict stroke disease remains limited. We aimed to investigate the associations between the modified TyG indices and incident stroke diseases and to compare their predictive power in a nationally representative cohort. Methods This was a prospective cohort study with longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS), which was based on data from four CHARLS surveys in 2011, 2013, 2015 and 2018, and included a total of 8677 participants. The Cox proportional risk model, Restricted Cubic Spline (RCS), and Receiver Operating Characteristic curve (ROC) were analyzed for the associations of TyG-BMI, TyG-WC and TyG-WHtR with stroke risk. In addition, the robustness of the findings was further validated using a series of sensitivity analyses and subgroup analyses. Results During the follow-up period from 2011 to 2018, 807 (9.3%) of the 8677 participants experienced stroke. After multifactorial adjustment (Model III), a 10-unit increase in TyG-BMI corresponded to a 5.5% increased risk of stroke (HR = 1.055, 95% CI 1.033–1.078), a 10-unit increase in TyG-WC corresponded to a 2.0% increased risk of stroke (HR = 1.020, 95% CI 1.012–1.027), and a 1-unit increase in TyG-WHtR corresponded to a 32.4% increased risk of stroke (HR = 1.324, 95% CI 1.178–1.487). Compared with individuals in the lowest quartile (Q1), those in higher quartiles showed progressively elevated risks. For TyG-BMI, adjusted hazard ratios increased by 39.1% (Q2), 62.1% (Q3), and 86.1% (Q4); for TyG-WC, by 40.6%, 63.0%, and 88.8%; and for TyG-WHtR, by 36.5%, 65.7%, and 83.7%, respectively. The RCS showed a nonlinear dose‒response relationship between TyG-BMI and stroke and a nonlinear dose‒response relationship between TyG-WC. In addition, TyG-WHtR had a linear dose‒response relationship with stroke. The area under the curve (AUC) values were 0.5930, 0.6078 and 0.6032, respectively, and all three had comparable predictive abilities for stroke risk, with TyG-WC having slightly greater predictive ability. The results of the sensitivity analysis and subgroup analysis were consistent with the main results. Conclusions In middle-aged and elderly populations, TyG-BMI, TyG-WC and TyG-WHtR are positively correlated with the risk of stroke. Maintaining favorable levels of these indices through weight and waist management may help reduce stroke risk. Graphical abstract |
| format | Article |
| id | doaj-art-6a463e6aa0d34437a7124fcfe1baf36b |
| institution | Kabale University |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Cardiovascular Diabetology |
| spelling | doaj-art-6a463e6aa0d34437a7124fcfe1baf36b2025-08-20T03:42:47ZengBMCCardiovascular Diabetology1475-28402025-07-0124111410.1186/s12933-025-02827-0Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort studyJiaan Sun0Xianglong Meng1Lichun Guo2Chongwen Nian3Haina Li4Wanxin Huang5Zhengzhou University Affiliated Zhengzhou Central HospitalZhengzhou University Affiliated Zhengzhou Central HospitalZhengzhou University Affiliated Zhengzhou Central HospitalZhengzhou University Affiliated Zhengzhou Central HospitalZhengzhou University Affiliated Zhengzhou Central HospitalZhengzhou University Affiliated Zhengzhou Central HospitalAbstract Objective Various modified triglyceride and glucose (TyG) indices have been proposed, but the literature on the impact and ability of the modified TyG index to predict stroke disease remains limited. We aimed to investigate the associations between the modified TyG indices and incident stroke diseases and to compare their predictive power in a nationally representative cohort. Methods This was a prospective cohort study with longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS), which was based on data from four CHARLS surveys in 2011, 2013, 2015 and 2018, and included a total of 8677 participants. The Cox proportional risk model, Restricted Cubic Spline (RCS), and Receiver Operating Characteristic curve (ROC) were analyzed for the associations of TyG-BMI, TyG-WC and TyG-WHtR with stroke risk. In addition, the robustness of the findings was further validated using a series of sensitivity analyses and subgroup analyses. Results During the follow-up period from 2011 to 2018, 807 (9.3%) of the 8677 participants experienced stroke. After multifactorial adjustment (Model III), a 10-unit increase in TyG-BMI corresponded to a 5.5% increased risk of stroke (HR = 1.055, 95% CI 1.033–1.078), a 10-unit increase in TyG-WC corresponded to a 2.0% increased risk of stroke (HR = 1.020, 95% CI 1.012–1.027), and a 1-unit increase in TyG-WHtR corresponded to a 32.4% increased risk of stroke (HR = 1.324, 95% CI 1.178–1.487). Compared with individuals in the lowest quartile (Q1), those in higher quartiles showed progressively elevated risks. For TyG-BMI, adjusted hazard ratios increased by 39.1% (Q2), 62.1% (Q3), and 86.1% (Q4); for TyG-WC, by 40.6%, 63.0%, and 88.8%; and for TyG-WHtR, by 36.5%, 65.7%, and 83.7%, respectively. The RCS showed a nonlinear dose‒response relationship between TyG-BMI and stroke and a nonlinear dose‒response relationship between TyG-WC. In addition, TyG-WHtR had a linear dose‒response relationship with stroke. The area under the curve (AUC) values were 0.5930, 0.6078 and 0.6032, respectively, and all three had comparable predictive abilities for stroke risk, with TyG-WC having slightly greater predictive ability. The results of the sensitivity analysis and subgroup analysis were consistent with the main results. Conclusions In middle-aged and elderly populations, TyG-BMI, TyG-WC and TyG-WHtR are positively correlated with the risk of stroke. Maintaining favorable levels of these indices through weight and waist management may help reduce stroke risk. Graphical abstracthttps://doi.org/10.1186/s12933-025-02827-0StrokeModified TyG indexCHARLSProspective cohort study |
| spellingShingle | Jiaan Sun Xianglong Meng Lichun Guo Chongwen Nian Haina Li Wanxin Huang Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study Cardiovascular Diabetology Stroke Modified TyG index CHARLS Prospective cohort study |
| title | Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study |
| title_full | Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study |
| title_fullStr | Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study |
| title_full_unstemmed | Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study |
| title_short | Association between modified triglyceride glucose indices and stroke risk in middle-aged and older Chinese adults: a prospective cohort study |
| title_sort | association between modified triglyceride glucose indices and stroke risk in middle aged and older chinese adults a prospective cohort study |
| topic | Stroke Modified TyG index CHARLS Prospective cohort study |
| url | https://doi.org/10.1186/s12933-025-02827-0 |
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