Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study

Abstract Background The triglyceride-glucose (TyG) index was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3. However, the relationship between cumulative of TyG (cumTyG) and incidence of stroke remains unclear in individuals wit...

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Main Authors: Lifei Lu, Yubiao Chen, Baiyun Liu, Xicong Li, Jiale Wang, Zhengchang Nie, Xiaodong Fu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Cardiovascular Diabetology
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Online Access:https://doi.org/10.1186/s12933-025-02754-0
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author Lifei Lu
Yubiao Chen
Baiyun Liu
Xicong Li
Jiale Wang
Zhengchang Nie
Xiaodong Fu
author_facet Lifei Lu
Yubiao Chen
Baiyun Liu
Xicong Li
Jiale Wang
Zhengchang Nie
Xiaodong Fu
author_sort Lifei Lu
collection DOAJ
description Abstract Background The triglyceride-glucose (TyG) index was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3. However, the relationship between cumulative of TyG (cumTyG) and incidence of stroke remains unclear in individuals with CKM syndrome stages 0–3. Method Participants with CKM syndrome stage 0–3 were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. TyG was calculated as ln [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)/2], and the cumTyG, as an area-under-the-curve estimate (mean TyG × time span), was calculated as (TyG2012 + TyG 2015)/2 * time (2015–2012). TyG control levels were classified using k-mean clustering analysis. Logistic regression was used to analyze the effect of cumTyG and TyG control levels on the incidence of stroke. Restricted cubic spline models (RCS) were performed to explore the potential non-linear relationship between cumTyG and stroke risk at different CKM syndrome stages 0–3. Results A total of 4,700 CKM syndrome stages 0–3 participants were enrolled, among 280 patients had developed stroke during the 3-year follow-up period. After adjusting for confounders, compared to class 1 group, the odds ratio (OR) of incidents of stroke for class 2 was 1.39 [95% confidence interval (CI) 1.003, 1.92], P = 0.046; the OR of incidents of stroke for class 3 was 1.28 (95% CI 0.92–1.77), P = 0.147, the OR of incidents of stroke for class 4 was 1.28 (95% CI 0.84–1.94), P = 0.238. Elevated cumTyG was associated with an increase in incidence of stroke (OR 1.13, 95% CI 1.05, 1.22, P = 0.002). The relationship between the cumTyG index and stroke was linear in restricted cubic spline regression. Conclusions Elevated cumTyG was associated with an increased risk of stroke events in the population of CKM syndrome stages 0–3. Long-term dynamic monitoring of changes of TyG may help in the early identification of patients at high risk of developing stroke in the individuals with CKM syndrome stages 0–3. Graphical Abstract
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spelling doaj-art-dffc84ccf36b464e8e3eddd4ed3163a72025-08-20T03:10:13ZengBMCCardiovascular Diabetology1475-28402025-05-0124111210.1186/s12933-025-02754-0Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort studyLifei Lu0Yubiao Chen1Baiyun Liu2Xicong Li3Jiale Wang4Zhengchang Nie5Xiaodong Fu6State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University920th Hospital of Joint Logistics Support Force, PLADepartment of Cardiology, Guangzhou Institute of Cardiovascular Disease, Guangdong Key Laboratory of Vascular Diseases, The Second Affiliated Hospital, Guangzhou Medical University920th Hospital of Joint Logistics Support Force, PLADepartment of Cardiology, Guangzhou Institute of Cardiovascular Disease, Guangdong Key Laboratory of Vascular Diseases, The Second Affiliated Hospital, Guangzhou Medical UniversityAbstract Background The triglyceride-glucose (TyG) index was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3. However, the relationship between cumulative of TyG (cumTyG) and incidence of stroke remains unclear in individuals with CKM syndrome stages 0–3. Method Participants with CKM syndrome stage 0–3 were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. TyG was calculated as ln [fasting triglyceride (mg/dL)×fasting glucose (mg/dL)/2], and the cumTyG, as an area-under-the-curve estimate (mean TyG × time span), was calculated as (TyG2012 + TyG 2015)/2 * time (2015–2012). TyG control levels were classified using k-mean clustering analysis. Logistic regression was used to analyze the effect of cumTyG and TyG control levels on the incidence of stroke. Restricted cubic spline models (RCS) were performed to explore the potential non-linear relationship between cumTyG and stroke risk at different CKM syndrome stages 0–3. Results A total of 4,700 CKM syndrome stages 0–3 participants were enrolled, among 280 patients had developed stroke during the 3-year follow-up period. After adjusting for confounders, compared to class 1 group, the odds ratio (OR) of incidents of stroke for class 2 was 1.39 [95% confidence interval (CI) 1.003, 1.92], P = 0.046; the OR of incidents of stroke for class 3 was 1.28 (95% CI 0.92–1.77), P = 0.147, the OR of incidents of stroke for class 4 was 1.28 (95% CI 0.84–1.94), P = 0.238. Elevated cumTyG was associated with an increase in incidence of stroke (OR 1.13, 95% CI 1.05, 1.22, P = 0.002). The relationship between the cumTyG index and stroke was linear in restricted cubic spline regression. Conclusions Elevated cumTyG was associated with an increased risk of stroke events in the population of CKM syndrome stages 0–3. Long-term dynamic monitoring of changes of TyG may help in the early identification of patients at high risk of developing stroke in the individuals with CKM syndrome stages 0–3. Graphical Abstracthttps://doi.org/10.1186/s12933-025-02754-0Triglyceride-glucoseCumulative of Triglyceride-glucoseThe China Health and Retirement Longitudinal StudyStrokeCardiovascular-kidney-metabolic syndrome
spellingShingle Lifei Lu
Yubiao Chen
Baiyun Liu
Xicong Li
Jiale Wang
Zhengchang Nie
Xiaodong Fu
Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
Cardiovascular Diabetology
Triglyceride-glucose
Cumulative of Triglyceride-glucose
The China Health and Retirement Longitudinal Study
Stroke
Cardiovascular-kidney-metabolic syndrome
title Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
title_full Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
title_fullStr Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
title_full_unstemmed Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
title_short Association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular-kidney-metabolic syndrome stage 0–3: a nationwide prospective cohort study
title_sort association between cumulative changes of the triglyceride glucose index and incidence of stroke in a population with cardiovascular kidney metabolic syndrome stage 0 3 a nationwide prospective cohort study
topic Triglyceride-glucose
Cumulative of Triglyceride-glucose
The China Health and Retirement Longitudinal Study
Stroke
Cardiovascular-kidney-metabolic syndrome
url https://doi.org/10.1186/s12933-025-02754-0
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