{"title":"Enhanced Stroke Risk Stratification Using Triglyceride-Glucose-Waist Circumference in Chinese Adults without diabetes.","authors":"Xiaoyan Wang, Shuchuan Miao","doi":"10.1016/j.amepre.2025.01.022","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance (IR) is a well-establsihed risk factor for stroke. However, the relationship between triglyceride-glucose (TyG) index, its modified indices‒TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and TyG-BMI‒and the risk of stroke in populations without diabetes remains underexplored.</p><p><strong>Methods: </strong>Data from the CHARLS on 4,029 participants without diabetes aged 45+ at baseline (2011‒2012) were analyzed, with follow-ups through 2020. Statistical analysis and modeling were performed in 2024. Incident strokes occurring between 2015 and 2020 were examined. TyG and its modified indices were categorized into tertiles and analyzed based on baseline levels, changes over time, and cumulative measures. Changes in TyG and its modified indices were identified using K-means clustering, while cumulative indices were calculated using a formula: (TyG<sub>2012</sub>+TyG<sub>2015</sub>)/2 × time <sub>(2015-2012)</sub>.</p><p><strong>Results: </strong>Between 2015 and 2020, 225 participants (5.6%) experienced a stroke. After full adjustment, for cofounders only TyG-WC remained significantly associated at each level across its baseline levels, changes, and cumulative measures (p < 0.05), outperforming TyG, TyG-WHtR and TyG-BMI. Compared to Tertile 1, AORs for stroke associated with TyG-WC were 1.64 (1.10‒2.47) in Tertile 2 and 1.79 (1.15‒2.82) in Tertile 3. For changes in TyG-WC, ORs were 1.70 (1.14‒2.60) in Class 2 and 1.80 (1.11‒2.97) in Class 3. Regarding cumulative TyG-WC: the ORs were: 1.61 (1.08‒2.41) for Tertile 2 and 1.70 (1.10‒2.66) for Tertile 3. Additionally, TyG-WC demonstrated superior predictive performance for stroke compared to other indices.</p><p><strong>Conclusions: </strong>TyG-WC is strongly associated with stroke risk in populations without diabetes, offering superior risk stratification compared to other TyG indices.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.01.022","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Insulin resistance (IR) is a well-establsihed risk factor for stroke. However, the relationship between triglyceride-glucose (TyG) index, its modified indices‒TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and TyG-BMI‒and the risk of stroke in populations without diabetes remains underexplored.
Methods: Data from the CHARLS on 4,029 participants without diabetes aged 45+ at baseline (2011‒2012) were analyzed, with follow-ups through 2020. Statistical analysis and modeling were performed in 2024. Incident strokes occurring between 2015 and 2020 were examined. TyG and its modified indices were categorized into tertiles and analyzed based on baseline levels, changes over time, and cumulative measures. Changes in TyG and its modified indices were identified using K-means clustering, while cumulative indices were calculated using a formula: (TyG2012+TyG2015)/2 × time (2015-2012).
Results: Between 2015 and 2020, 225 participants (5.6%) experienced a stroke. After full adjustment, for cofounders only TyG-WC remained significantly associated at each level across its baseline levels, changes, and cumulative measures (p < 0.05), outperforming TyG, TyG-WHtR and TyG-BMI. Compared to Tertile 1, AORs for stroke associated with TyG-WC were 1.64 (1.10‒2.47) in Tertile 2 and 1.79 (1.15‒2.82) in Tertile 3. For changes in TyG-WC, ORs were 1.70 (1.14‒2.60) in Class 2 and 1.80 (1.11‒2.97) in Class 3. Regarding cumulative TyG-WC: the ORs were: 1.61 (1.08‒2.41) for Tertile 2 and 1.70 (1.10‒2.66) for Tertile 3. Additionally, TyG-WC demonstrated superior predictive performance for stroke compared to other indices.
Conclusions: TyG-WC is strongly associated with stroke risk in populations without diabetes, offering superior risk stratification compared to other TyG indices.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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