What is the clinical evidence from this study?

Study design: Cohort. Population: Incident stroke in non-hypertensive adults (n=7769). Intervention: Triglyceride-glucose (TyG) index vs. Lower TyG index levels. Primary outcome: Incident stroke (HR 1.33, 95% CI 1.14-1.55, p=0.0004).

What does this research mean for the field?

Higher TyG index is associated with an increased risk of incident stroke in non-hypertensive adults under standard models, but the association becomes non-significant after accounting for competing mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 14, 2026Scientific ReportsOpen Access

Association between triglyceride glucose index and incident stroke in nonhypertensive Chinese adults

Q: What are the key findings of this study?

Each 1-unit increase in the TyG index was associated with a 33% higher risk of incident stroke (HR 1.33), though this association became non-significant after accounting for competing mortality.

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Key result

Higher TyG index linked to ~33% greater stroke risk before accounting for competing mortality.

HR 1.33
95% CI 1.14-1.55
P=0.0004
n=7,769

Why the study?

This study aimed to investigate the prospective relationship between the triglyceride–glucose (TyG) index and incident stroke in a nationally representative cohort of non-hypertensive Chinese adults.

Does a higher triglyceride-glucose (TyG) index increase the risk of incident stroke in non-hypertensive Chinese adults?

Population

7769 non-hypertensive Chinese adults

Comparison

Higher vs lowest TyG index tertiles

Design

Nationally representative prospective cohort study

Follow-up

Median 9.0 years (IQR, 8.92–9.00 years)

Authors

HYHuan YangXian Central Hospital JZJingjing ZhangSecond Affiliated Hospital of Xi'an Jiaotong University XWXiaochuang WangShihezi University

Discussion

Member takes

Implication

TyG index was associated with incident stroke; hypothesis-generating and should not yet change practice in non-hypertensive adults.

Key Points

To evaluate the prospective relationship between the triglyceride–glucose (TyG) index and incident stroke among non-hypertensive adults.
Analyzed 7,769 non-hypertensive Chinese adults from the China Health and Retirement Longitudinal Study followed for a median duration of 9.0 years (interquartile range, 8.92–9.00 years).
Calculated baseline TyG index from fasting triglycerides and glucose, categorizing participants into tertiles, with stroke identified through self-reported physician diagnoses.
Estimated hazard ratios with multivariable Cox proportional hazards models and evaluated competing mortality using the Fine–Gray subdistribution hazard model.
Stroke incidence over follow-up was 4.67% in the lowest TyG tertile, 7.34% in the middle tertile, and 8.07% in the highest tertile (P < 0.001).
In fully adjusted Cox models, each 1-unit increase in TyG was associated with stroke (HR = 1.33, 95% CI: 1.14–1.55; P = 0.0004), with higher risk in the middle (HR = 1.47, 95% CI: 1.16–1.87) and highest tertiles (HR = 1.54, 95% CI: 1.19–1.99) versus the lowest.
Accounting for competing mortality in the Fine–Gray model attenuated the association to statistical insignificance (subdistribution HR = 0.98, 95% CI: 0.92–1.04; P = 0.524).

Study Design

Type

Cohort (n=7,769)

Multicenter

Yes

Structured PICO

Does a higher triglyceride-glucose (TyG) index increase the risk of incident stroke in non-hypertensive Chinese adults?

Population

7,769 non-hypertensive Chinese adults aged 45 years and older, free of prior stroke, followed for a median of 9.0 years.

Exposure

Higher triglyceride-glucose (TyG) index levels, specifically the middle (8.32-8.82) and high (8.82-12.41) tertiles

Comparator

Lowest tertile of TyG index (6.00-8.32)

Outcome

Incident stroke (first self-reported physician-diagnosed stroke occurring after baseline)hard clinical

Main Result

Hazard Ratio: 1.33 (95% CI 1.14–1.55)

p-value: p=0.0004

While the TyG index is associated with incident stroke in conventional models, this association is attenuated by competing mortality, suggesting it is a marker of general metabolic vulnerability rather than a stroke-specific predictor.

Limitations

Stroke outcomes were based on self-reported physician diagnoses without subtype information.
TyG was measured only at baseline, precluding assessment of longitudinal changes.
Exact dates of stroke onset were unavailable, introducing potential interval-censoring.
Residual and unmeasured confounding cannot be excluded.
Exclusion of a substantial number of baseline participants may have introduced selection bias.
Stroke outcomes were based on self-reported physician diagnoses, and information on stroke subtype was unavailable
TyG was measured only at baseline, precluding assessment of longitudinal changes and potentially resulting in regression dilution bias
Exact dates of stroke onset were unavailable, which may have introduced interval-censoring
Residual and unmeasured confounding cannot be excluded
Exclusion of a substantial number of baseline participants may have introduced selection bias

Cite This Study

Yang et al. (2026) conducted a cohort in Incident stroke in non-hypertensive adults (n=7,769). Triglyceride-glucose (TyG) index vs. Lower TyG index levels was evaluated on Incident stroke (HR 1.33, 95% CI 1.14-1.55, p=0.0004). Each 1-unit increase in the TyG index was associated with a 33% higher risk of incident stroke (HR 1.33), though this association became non-significant after accounting for competing mortality.

synapsesocial.com/papers/6a7ec6eab70b84ec8b912fcb https://doi.org/10.1038/s41598-026-66364-w

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Association between triglyceride glucose index and incident stroke in nonhypertensive Chinese adults

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Association between triglyceride glucose index and incident stroke in nonhypertensive Chinese adults

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider