ArticleScientific reports2026
Joint association of triglyceride-glucose index and atherogenic lipid markers with incident stroke risk.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The triglyceride-glucose (TyG) index and atherogenic cholesterol markers, including non-HDL cholesterol and remnant cholesterol, are significant predictors of atherosclerotic cardiovascular disease (ASCVD). However, the joint effects and predictive value of TyG and atherogenic cholesterol markers for incident stroke remain insufficiently understood. We included participants from the China Health and Retirement Longitudinal Study (CHARLS) enrolled at baseline in 2011 and followed them through 2020. Participants were categorized into four groups according to the median values of the TyG index and each cholesterol marker, with those having both values below the median serving as the reference group. Cox proportional hazards models were used to evaluate the independent and joint associations of TyG and atherogenic cholesterol markers with incident stroke. Restricted cubic spline models were applied to assess dose-response relationships, and receiver operating characteristic (ROC) curve analyses were used to examine predictive performance. A total of 8,544 participants were included (mean [SD] age 59.0 [9.5] years; 52.1% female). 522 incident stroke events occurred during a maximum follow-up of 9.0 years. TyG, non-HDL cholesterol and remnant cholesterol were all independently associated with stroke risk. Compared with participants with both TyG and cholesterol markers below median, those with both markers above median had the greatest stroke risk in fully adjusted models (HR for high TyG and high non-HDL cholesterol: 1.76 [95% CI 1.41-2.20]; HR for high TyG and high remnant cholesterol: 1.45 [95% CI 1.18-1.77]). Adding TyG and each cholesterol marker to traditional risk factors modestly improved risk discrimination, with the model combining TyG and non-HDL cholesterol yielding the highest AUC. The TyG index and atherogenic cholesterol markers were independently and jointly associated with increased stroke risk among middle-aged and older adults. Adding these routinely available metabolic and lipid markers modestly improved discrimination for incident stroke.
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