Integrated TyG index and eGDR measure enhances stroke risk stratification in early cardiovascular-kidney-metabolic syndrome: A prospective national cohort analysis
Year: 2025
Type: article
Abstract: BACKGROUND: The triglyceride-glucose (TyG) index and estimated glucose disposal rate (eGDR) are established markers of insulin resistance (IR), yet their combined role in predicting stroke among individuals with early-stage cardiovascular-kidney-metabolic (CKM) syndrome remains unclear. METHODS: We included 4,414 participants from the China Health and Retirement Longitudinal Study (CHARLS) with baseline (2011) and follow-up (2015) data. TyG-eGDR was calculated at both timepoints, and cumulative exposure was derived. K-means clustering categorized participants into three dynamic trajectory groups. Cox proportional hazards models evaluated stroke risk, restricted cubic splines (RCS) tested nonlinearity, and receiver operating characteristic (ROC) curves assessed predictive performance. RESULTS: Over the follow-up period, 219 stroke events occurred. Compared to the low TyG-eGDR trajectory group, the high-trajectory group had a 2.84-fold increased stroke risk (HR = 2.84, 95 % CI: 1.67-4.81). Participants with the highest cumulative TyG-eGDR exposure exhibited a 4.28-fold increased stroke risk (HR = 4.28, 95 % CI: 2.66-6.89), while those with high baseline levels had a 3.46-fold elevated risk (HR = 3.46, 95 % CI: 1.82-6.58). RCS analyses revealed significant nonlinear relationships between TyG-eGDR indices and stroke (P < 0.05). CONCLUSIONS: Sustained high TyG-eGDR levels predict stroke risk in early CKM syndrome, supporting its integration into routine metabolic cerebrovascular risk assessment.
Authors: Xiaolei Wang, Hongfeng Sun, Taojing Zhang, Hui Zhou
Institution: Beijing University of Chinese Medicine
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,170
Award: G5834274334
OpenAlex ID: W4417047234