Triglyceride-glucose index trajectory and stroke incidence in patients with hypertension: a prospective cohort study

作者：Zegui Huang, Xiong Ding, Qing Yue, Xianxuan Wang, Zekai Chen, Zefeng Cai, Weijian Li, Zhiwei Cai, Guanzhi Chen, Yulong Lan, Weiqiang Wu, Shouling Wu, Youren Chen · 发表于：Cardiovascular Diabetology · 年份：2022 · DOI：10.1186/s12933-022-01577-7 · 被引用次数：202 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Function and Risk Factors、Hyperglycemia and glycemic control in critically ill and hospitalized patients

BACKGROUND: It has been suggested that the baseline triglyceride-glucose (TyG) index, a simple surrogate measure for insulin resistance, is significantly associated with the occurrence of stroke. Nevertheless, the impact of longitudinal patterns of TyG on the stroke risk in hypertensive patients is still unknown. Hence, this study aimed to investigate the association between TyG index trajectory and stroke risk among hypertensive patients. METHODS: This prospective study included 19,924 hypertensive patients from the Kailuan Study who underwent three waves survey and were free of myocardial infarction, cancer and stroke before or during 2010. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2], and latent mixed modelling was used to identify the trajectory of TyG during the exposure period (2006-2010). Furthermore, the Cox proportional hazard models were applied to estimate the hazard ratio (HR) and 95% confidence interval (CI) for incident stroke of different trajectory groups. RESULTS: Five distinct TyG trajectory were identified during 2006-2010: low-stable (n = 2483; range, 8.03-8.06), moderate low-stable (n = 9666; range, 8.58-8.57), moderate high-stable (n = 5759; range, 9.16-9.09), elevated-stable (n = 1741; range, 9.79-9.75), and elevated-increasing (n = 275; range, 10.38-10.81). During the median follow-up of 9.97 years, 1,519 cases of incident stroke were identified, including 1,351 with ischemic stroke and 215 with h...