Individuals with both a high TyG-AIP index and hypertension had a significantly increased risk of incident stroke (HR 2.89) compared to those with low TyG-AIP and no hypertension.
Cohort (n=5,786)
Sí
Does a high TyG-AIP index combined with hypertension increase the risk of incident stroke in adults aged ≥45 years?
The combination of the TyG-AIP index and hypertension synergistically increases the risk of incident stroke, suggesting that integrating metabolic and hemodynamic assessments improves stroke risk stratification.
Estimación del efecto: HR 2.89 (95% CI 2.22-3.76)
valor p: p=<0.001
Abstract Background The triglyceride-glucose index (TyG) and the atherogenic index of plasma (AIP) are well-established indicators of insulin resistance and lipid metabolism, respectively, and both are associated with stroke risk. However, the joint impact of TyG and AIP—expressed as their product (TyG-AIP)—and its longitudinal trajectory on stroke risk have not been investigated. Moreover, it remains unclear whether TyG-AIP interacts synergistically with hypertension to improve stroke risk prediction. Methods This prospective cohort study included 5786 participants, categorized into dysglycemia (PDM, n = 3,490) and normoglycemia (NDM, n = 2,296) groups. TyG-AIP was calculated as the product of TyG and AIP. K-means clustering was applied to identify distinct patterns of TyG-AIP change between the two measurement points. Multivariable Cox proportional hazards models, restricted cubic splines, and receiver operating characteristic (ROC) analyses evaluated associations and predictive performance. Results Over 8 years of follow-up, 460 incident stroke cases occurred. Higher TyG-AIP levels were independently associated with an increased risk of stroke (per SD increase: HR = 1.35, 95% CI 1.21–1.51; P < 0.001), with a stronger effect among those with dysglycemia (HR = 1.54, 95% CI 1.21–1.95; P < 0.001). A nonlinear association was observed ( P for nonlinearity = 0.002). TyG-AIP synergistically interacted with hypertension, and individuals with both high TyG-AIP and hypertension had the greatest risk (HR = 2.89, 95% CI 2.22–3.76). The “high-and-declining” TyG-AIP trajectory conferred the highest stroke risk in the PDM group (HR = 2.26, 95% CI 1.62–3.15; P < 0.001). ROC analysis showed that a model combining TyG-AIP with hypertension (AUC = 0.643) provided improved discrimination compared to hypertension alone (AUC = 0.571). Conclusions TyG-AIP is associated with increased stroke risk, particularly in dysglycemic individuals, and exhibits joint effects with hypertension. The integration of TyG-AIP assessment with hypertension status enhances risk stratification, supporting comprehensive management of both metabolic and hemodynamic factors in stroke prevention. Graphical abstract
Zou et al. (Thu,) conducted a cohort in Stroke (n=5,786). High TyG-AIP index combined with hypertension vs. Low TyG-AIP index and no hypertension was evaluated on Incident stroke (HR 2.89, 95% CI 2.22-3.76, p=<0.001). Individuals with both a high TyG-AIP index and hypertension had a significantly increased risk of incident stroke (HR 2.89) compared to those with low TyG-AIP and no hypertension.