Association between Triglyceride-Glucose indices and ischemic stroke risk across different glucose metabolism statuses.

Background: Triglyceride-glucose (TyG) related indices, including TyG, TyG-body mass index (TyG-BMI), and TyG-waist circumference (TyG-WC), have been identified as promising biomarkers for assessing insulin resistance (IR), a known risk factor for ischemic stroke. While previous research has highlighted the relevance of these indices in various metabolic disorders, their predictive utility for ischemic stroke across different glucose metabolic statuses has not been extensively explored.

Methods: This study utilized data from the UK Biobank, analyzing 392,733 participants free from ischemic stroke at baseline, categorized into normal glucose, prediabetes, and diabetes groups based on American Diabetes Association criteria. TyG-related indices were computed using baseline measures of fasting blood glucose and triglycerides. Participants were followed for a median of 14.68 years to assess the incidence of ischemic stroke. Cox proportional hazards models adjusted for demographic and clinical covariates were used to explore the associations between TyG indices and stroke risk.

Results: Over the follow-up period, 8033 participants experienced an ischemic stroke. Higher TyG-related indices were associated with an increased stroke risk in all glucose metabolism groups, with the strongest associations observed in the prediabetes and normal glucose groups. The risk of stroke increased progressively across quartiles of TyG, TyG-BMI, and TyG-WC indices. The analysis revealed that each unit increase in the TyG index significantly elevated stroke risk in diabetic individuals, while TyG-BMI and TyG-WC indices showed significant predictive power in the prediabetes and normal glucose groups.

Conclusions: TyG-related indices, particularly TyG-BMI and TyG-WC, are effective in predicting the risk of ischemic stroke, especially among individuals with prediabetes and normal glucose levels. These findings underscore the utility of TyG indices as tools for early detection and preventive strategies in stroke risk management across various states of glucose metabolism.