What question did this study set out to answer?

This research investigates how the triglyceride-glucose index and atherogenic cholesterol markers predict the risk of stroke.

June 14, 2026Scientific ReportsOpen Access

Joint association of triglyceride-glucose index and atherogenic lipid markers with incident stroke risk

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Incident stroke (n=8544). Intervention: High TyG index and high non-HDL cholesterol vs. TyG index and non-HDL cholesterol below median. Primary outcome: First incident stroke (HR 1.76, 95% CI 1.41-2.20).

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Key result

Combined high TyG index and non-HDL cholesterol linked to ~76% higher incident stroke risk.

HR 1.76
95% CI 1.41-2.20
n=8,544

Why the study?

Do high triglyceride-glucose index and atherogenic lipid markers jointly increase the risk of incident stroke in middle-aged and older adults?

Population

8,544 participants from the China Health and Retirement Longitudinal Study

Comparison

Groups categorized by median values of TyG index and atherogenic cholesterol markers

Design

Longitudinal cohort study

Follow-up

Maximum follow-up of 9.0 years

Authors

LYLaiang YaoUniversity of California, Irvine GSGuiling SunLinyi People's Hospital LZLanju ZhangLinyi People's Hospital

Discussion

Member takes

Implication

Combined TyG and atherogenic cholesterol markers may refine stroke risk stratification; leaves open whether this improves clinical decisions or outcomes.

Key Points

This research investigates how the triglyceride-glucose index and atherogenic cholesterol markers predict the risk of stroke.
Included 8,544 participants from the China Health and Retirement Longitudinal Study (CHARLS) with a mean age of 59 years.
Categorized participants based on median triglyceride-glucose index and cholesterol marker values, utilizing Cox proportional hazards models for analysis.
Employed receiver operating characteristic (ROC) curve analyses to examine predictive performance.
TyG index, non-HDL cholesterol, and remnant cholesterol are independently associated with increased stroke risk.
Participants with elevated levels of both TyG and non-HDL cholesterol had a stroke risk with HR of 1.76 (95% CI 1.41–2.20).
Adding these metabolic markers to traditional risk factors modestly improved stroke risk discrimination, with the highest AUC observed for combining TyG and non-HDL cholesterol.

Study Design

Type

Cohort (n=8,544)

Multicenter

Yes

Structured PICO

Do high triglyceride-glucose index and atherogenic lipid markers jointly increase the risk of incident stroke in middle-aged and older adults?

Population

8,544 middle-aged and older Chinese adults aged 45 years and older, free of prior stroke or heart disease, followed for a maximum of 9.0 years.

Exposure

High triglyceride-glucose (TyG) index and high atherogenic cholesterol markers (non-HDL cholesterol or remnant cholesterol) above median values

Comparator

Both TyG index and atherogenic cholesterol markers below median values

Outcome

First incident stroke during follow-up (ascertained through self-reported physician diagnosis)hard clinical

Main Result

Hazard Ratio: 1.76 (95% CI 1.41–2.2)

The combination of a high triglyceride-glucose index and high atherogenic cholesterol markers is independently and jointly associated with an increased risk of incident stroke, modestly improving risk discrimination beyond traditional risk factors.

Limitations

Observational design cannot establish causality.
Possibility of residual or unmeasured confounding, including lifestyle and unmeasured comorbidities.
Lack of detailed information on treatment changes, medication adherence, and interventions during follow-up.
Stroke events were ascertained via self-reported physician diagnosis, which may introduce recall bias and outcome misclassification.
Lack of detailed information on stroke subtype (ischemic vs. hemorrhagic), severity, and imaging confirmation.
Biomarkers were only assessed at baseline, not accounting for changes or trajectories over time.
Potential selection bias due to attrition from loss to follow-up.
Findings in Chinese adults aged ≥45 years may not generalize to younger individuals or other ethnic groups.

Cite This Study

Yao et al. (2026) conducted a cohort in Incident stroke (n=8,544). High TyG index and high non-HDL cholesterol vs. TyG index and non-HDL cholesterol below median was evaluated on First incident stroke (HR 1.76, 95% CI 1.41-2.20). High TyG index combined with high non-HDL cholesterol was associated with a significantly increased risk of incident stroke compared to having both markers below the median (HR 1.76).

synapsesocial.com/papers/6a2e45d5b1cc60ccdea8ab9c https://doi.org/10.1038/s41598-026-56940-5

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Implication

Combined TyG and atherogenic cholesterol markers may refine stroke risk stratification; leaves open whether this improves clinical decisions or outcomes.

Joint association of triglyceride-glucose index and atherogenic lipid markers with incident stroke risk

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Joint association of triglyceride-glucose index and atherogenic lipid markers with incident stroke risk

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider