Differential associations between novel triglyceride-glucose-obesity indices and incident stroke in individuals with early-stage cardiovascular-kidney-metabolic syndrome: a longitudinal cohort study
Authors' conclusion
Among the six novel TyG-obesity indices evaluated, TyG-CVAI and TyG-BRI emerged as stronger predictors of incident stroke in individuals with early-stage CKM syndrome, particularly in stage 2. These findings highlight the potential utility of these two indices for stroke risk stratification and may inform early detection strategies in this vulnerable population.
Study context
- Population
- Individuals with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3, China Health and Retirement Longitudinal Study
- Participants
- 3,400 individuals
- Exposure
- Six novel triglyceride-glucose (TyG)-obesity indices and incident stroke
- Outcome
- Incident stroke
- Follow-up
- Median 8.6 years
Methodological detailsK-means clustering of longitudinal change patterns, Cox proportional hazards models, restricted cubic splines, ROC, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses
- K-means clustering of longitudinal change patterns
- Cox proportional hazards models
- Restricted cubic splines
- ROC, NRI and IDI analyses
Main finding
As reported in the abstract
Incident strokes
232
Baseline TyG-CVAI per SD, HR
1.36 (1.17-1.57) (95% CI)
Baseline TyG-BRI per SD, HR
1.32 (1.14-1.53) (95% CI)
Observational data: associations, not effects.
Further findings
Cumulative index and stroke
- Cumulative TyG-CVAI, HR
- 1.31 (1.14-1.52)
- Cumulative TyG-BRI, HR
- 1.29 (1.11-1.49)
Sustained high-level vs stable low-level change pattern and stroke
- TyG-CVAI, HR
- 2.28 (1.54-3.39)
- TyG-BRI, HR
- 2.01 (1.35-2.99)
- Reference: stable low-level group
Stage-specific, dose-response and discrimination analyses
- Stronger associations in CKM stage 2
- Both indices showed positive linear dose-response relationships
- TyG-CVAI and TyG-BRI had relatively better discrimination (ROC); NRI/IDI showed incremental predictive value over baseline model
Original publication
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