Insulin resistance (IR) is an independent risk factor of cardiovascular disease.
Recent research has proposed a new inexpensive and reliable indicator of IR:
triglyceride glucose index (TyG index). We aim to evaluate the dose-response
association between the TyG index and stroke through meta-analysis. Literature
published from inception until October 2021 were searched in PubMed, Embase,
Cochrane Library and Web of science. Cohort studies published in English and
focusing on the association between the TyG index and stroke were included in
our meta-analysis. I2 statistic and Chi-square were used to assess
the heterogeneity. When I2≥30% or p≤0.10, the
random-effect model was used to pool the effect; otherwise, we chose the
fixed-effect model. Eleven cohort studies, including 5 721 077 subjects and 95
490 stroke patients, were included in our study. After pooling the effect
adjusted by multiple confounders, we found that compared with the lowest
baseline TyG index group, the highest one was independently associated with
increased stroke risk (RR: 1.27; 95% CI, 1.24 to 1.29;
I2=6%). Dose-response meta-analysis showed that the
association between the two variables had a non-linear trend
(p-nonlinearity<0.0001; p-heterogeneity=0.28). Subgroup analysis
showed that the risk of ischemic stroke was positively correlated with TyG index
(RR: 1.48; 95% CI, 1.34 to 1.62; I2=15%),
while we did not observe this correlation in hemorrhagic stroke patients. In
patients with type 2 diabetes and acute coronary syndrome, the TyG index was
linearly correlated with incident strokes. In conclusion, elevated TyG index is
the independent risk factor for incident strokes (especially ischemic
stroke).
Key words
triglyceride-glucose index -
insulin resistance -
stroke -
meta-analysis
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