Joint association of triglyceride-glucose (TyG) and atherogenic index of plasma (AIP) with stroke risk: findings from a nationwide prospective cohort

作者：Chongwen Nian, Yunyun Huang, Xiwen Ma, Xianglong Meng, Lichun Guo, Weiping Tian, Hongxia Li, Yabin Zhao, Jiaan Sun · 发表于：Cardiovascular Diabetology · 年份：2026 · DOI：10.1186/s12933-026-03136-w · 被引用次数：1 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Health and Disease Prevention、Cardiovascular Function and Risk Factors

BACKGROUND: The triglyceride-glucose (TyG) index and the atherogenic index of plasma (AIP) are established surrogate markers for insulin resistance and dyslipidemia, respectively, each independently linked to stroke. However, their combined predictive value for stroke is underexplored. Consequently, this study aims to evaluate the predictive performance of the combined TyG and AIP indices for incident stroke in a middle-aged and elderly Chinese cohort. METHODS: We included 7652 adults aged ≥ 45 years without baseline stroke from the China Health and Retirement Longitudinal Study (CHARLS). TyG and AIP were calculated and dichotomized by median. The primary outcome was new-onset stroke. Cox proportional hazards models assessed associations, examining interactions on both additive (Relative Excess Risk due to Interaction, RERI) and multiplicative scales. Restricted cubic spline (RCS) analysis was used to examine nonlinear relationships. Predictive performance was assessed using area under the receiver operating characteristic curve (AUC), and model performance differences were evaluated using the DeLong test, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULT: Over 9 years, 744 strokes (9.72%) occurred. High TyG (HR = 1.41, 95% CI 1.21–1.64) and high AIP (HR = 1.44, 1.24-1.67) independently increased risk. The combination showed highest risk (HR = 1.49, 1.27-1.75). AIP had a nonlinear association (inflection ~ 0.22); TyG was linear. T...