Full
Outline
To investigate the correlation and dose-response relationship between the triglyceride glucose-body mass index (TyG-BMI) and the incidence of stroke.
A prospective cohort study design was employed to compare differences in demographic characteristics, behavioral lifestyles, family history, and blood biochemical results between individuals who developed stroke and those who did not. All subjects were divided into four groups, Q1 to Q4, based on the quartiles of TyG-BMI in ascending order. The Cox proportional hazards regression model was used to analyze the association between TyG-BMI and stroke risk, calculating the hazard ratio (HR) and its 95% confidence interval (CI). A Restricted Cubic Spline (RCS) model was used to analyze the dose-response relationship between TyG-BMI and stroke risk. After the RCS analysis suggested a nonlinear trend, we further utilized the segmented package in R software to perform piecewise Cox regression to identify the threshold effect. The goodness of fit of the models was compared using the Davies test and the likelihood ratio test.
This study included 17 173 subjects with a median follow-up time of 19.5 years. During the follow-up period, 2 374 new stroke cases occurred, with an incidence density of 805 per 100 000 person-years. Significant differences(P<0.05) were observed between the stroke group and the non-stroke group in terms of age, education level, income, physical activity intensity, history of hypertension, family history of stroke, systolic blood pressure (SBP), diastolic blood pressure (DBP),body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and TyG-BMI. After adjusting for confounding factors, the risk of stroke gradually increased with rising TyG-BMI levels (P<0.001). Compared to the Q1 group, the risk of new-onset stroke increased by 18.1% (HR=1.181, 95% CI: 1.037-1.346), 33.3% (HR=1.333, 95% CI: 1.171-1.517), and 57.0% (HR=1.570, 95% CI: 1.366-1.804) in the Q2, Q3, and Q4 groups, respectively. The RCS analysis showed a positive association between TyG-BMI and stroke risk (P for overall <0.05), and a non-linear dose-response relationship was identified (P for non-linearity <0.05). Piecewise Cox regression identified a threshold value of 214.3,and the likelihood ratio test confirmed that the piecewise model had a significantly better fit than the traditional linear model (P=0.037). On both sides of the threshold, each unit increase in TyG-BMI was significantly associated with an increased risk of stroke (below the threshold: HR=1.151, 95% CI: 1.032-1.325, P<0.001; above the threshold: HR=1.232, 95% CI: 1.085-1.418,P<0.001).
TyG-BMI exhibits a nonlinear dose-response relationship with the risk of stroke, with a significant threshold effect identified at 214.3. The risk of stroke increased more markedly when TyG-BMI exceeded this threshold. TyG-BMI may serve as a simple indicator for stroke risk screening in rural community populations.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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