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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BMC
2025-05-01
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| 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 |
| format | Article |
| id | doaj-art-dffc84ccf36b464e8e3eddd4ed3163a7 |
| institution | DOAJ |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Cardiovascular Diabetology |
| 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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