Association of novel triglyceride-glucose-related indices with incident stroke in early-stage cardiovascular-kidney-metabolic syndrome
Main finding · Incident strokeResult — go to the resultHazard ratio 1.67 95% CI 1.28–2.18Authors' conclusion
Novel TyG-related indices, particularly TyG-CVAI, showed significant and incremental predictive value for stroke risk among individuals with CKM syndrome stages 0-3. Their incorporation into risk stratification frameworks may enhance early detection and prevention of cerebrovascular events in metabolically vulnerable populations.
Study context
- Population
- Middle-aged and older adults with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3, China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 7,503 participants
- Exposure
- Per 1-SD increase in triglyceride-glucose (TyG)-related indices (TyG-BRI, TyG-ABSI, TyG-WWI, TyG-CVAI); highest vs lowest TyG-CVAI quartile
- Outcome
- Incident stroke
- Follow-up
- Median 5.2 years
Methodological detailsCox proportional hazards models, restricted cubic splines, mediation analysis
- Cox proportional hazards models
- Restricted cubic splines
- Mediation analysis
Main finding
As reported in the abstract
Hazard ratio
1.67
95% CI 1.28–2.18
Highest TyG-CVAI quartilevs Lowest TyG-CVAI quartile
HR 1.67 (95% CI 1.28–2.18)
- Incident first stroke
- 625 participants (8.33%); incidence rate 102.18 per 10,000 person-years
- HR per 1-SD increase in TyG-BRI
- 1.16 (1.06-1.27) (95% CI)
- HR per 1-SD increase in TyG-ABSI
- 1.10 (1.01-1.21) (95% CI)
- HR per 1-SD increase in TyG-WWI
- 1.13 (1.03-1.25) (95% CI)
- HR per 1-SD increase in TyG-CVAI
- 1.20 (1.10-1.31) (95% CI)
Observational data: associations, not effects.
Further findings
Nonlinear thresholds
- TyG-BRI threshold
- 18.16
- TyG-WWI threshold
- 78.93
Discrimination (ROC)
- TyG-CVAI had the greatest discriminative ability for predicting stroke
Mediation by systolic blood pressure (SBP)
- Proportion mediated by SBP
- 26.3-32.9%
Subgroup and sensitivity analyses
- Findings consistent across multiple subgroup and sensitivity analyses
Original publication
Association of novel triglyceride-glucose-related indices with incident stroke in early-stage cardiovascular-kidney-metabolic syndrome. Cardiovasc Diabetol. Published 24 July 2025. doi:10.
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