Evidence map›Paper›PMID 41398673›Full record

ArticleCardiovascular diabetology2025

Additive value of combining triglyceride-glucose index and estimated glucose disposal rate for incident stroke prediction across glycaemic-regulation subgroups: a prospective cohort of 5,789 Chinese adults.

Xuelun Zou, Feng Zhang, Cailin He, Wuyang Zhang, Rongmei Tang, Juan Zhu, Junyi Ma, Ye Li, Li Wang, Chaoyang Cai and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Xuelun ZouDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Feng ZhangDepartment of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Cailin HeDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Wuyang ZhangClinical Skills Training Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China.
Rongmei TangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Juan ZhuDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Junyi MaDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Ye LiDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Li WangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Chaoyang CaiDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Qiaoling TangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Yexiang YiDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Ran LiuDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Kexian ZhouDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Xiangbin ZhangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Yi ZengDepartment of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Le ZhangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. zlzdzlzd@csu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke is a leading contributor to the high disease burden in low- and middle-income countries, making early prevention essential for risk reduction. The triglyceride-glucose (TyG) index and the estimated glucose disposal rate (eGDR) are surrogate markers of insulin resistance, and both have been associated with cardiometabolic risk. However, the predictive utility of their combined use for stroke risk across different glucose metabolism states remains unclear.

methodsThis prospective cohort study enrolled 5789 stroke-free participants aged ≥ 45 years, including 3490 with abnormal glucose regulation(AGR) and 2296 with normal glucose regulation(NGR). The TyG-eGDR index was dichotomised as TyG × eGDR. The TyG + eGDR combination was further partitioned into 12 strata defined by TyG tertiles crossed with eGDR quartiles. We evaluated the relationship between theseTyG, eGDR, TyG-eGDR and TyG + eGDR categories and incident stroke using cox proportional-hazards models, mediation analysis, restricted cubic splines, receiver-operating-characteristic curves, and subgroup analyses Query.

resultsAmong 5789 participants followed for incident stroke, 460 new events were documented, corresponding to an overall incidence of 9.93 per 1000 person-years. We observed a negative association between lower eGDR index (OR = 0.70, 95% CI 0.62-0.79) and lower TyG-eGDR index (OR = 0.72, 95% CI 0.63-0.81) with stroke risk across all populations, while in the AGR subgroup, a higher TyG index (OR = 1.24, 95% CI 1.11-1.37) was associated with a higher risk of stroke. Compared to the reference group (low TyG and high eGDR), the combination of high TyG (≥ 8.90) and low eGDR (< 7.09) conferred the highest stroke hazard (HR = 3.75, 95% CI 2.29-6.15, p = 1.6 × 10⁻⁷), and this pattern was consistent in both AGR and NGR sub-cohorts. However, the TyG + eGDR combination exerted a stronger influence on stroke risk within the AGR group. RCS showed non-linear dose-response for TyG and TyG-eGDR with stroke (p < 0.05), but linear for eGDR. The TyG + eGDR composite model achieved superior discrimination (area under the ROC curve: 0.71). Mediation analysis indicated that eGDR accounted for 29.99% of the association between TyG and stroke risk, while TyG explained 5.81% of the association between eGDR and stroke risk; comparable mediation patterns were observed in the AGR population but not in the NGR population.

conclusionsLow eGDR and a low TyG-eGDR product independently predict a higher stroke risk, whereas elevated TyG predominantly increases stroke risk in individuals with AGR. Combining TyG and eGDR markedly improves stroke discrimination beyond either metric alone. Routine integration of these two inexpensive indices permits earlier, more precise risk stratification and can inform targeted interventions that substantially reduce stroke incidence.

Indexed as

Blood GlucoseStrokeTriglyceridesAgedBiomarkersChinaEast Asian PeopleFemaleHumansIncidenceInsulin ResistanceMaleMiddle AgedPredictive Value of TestsPrognosisProspective StudiesBiomarkersBlood GlucoseTriglyceridesDiabetesEstimated glucose disposal rateGlycaemic regulationStrokeTriglyceride-glucose index

Identifiers

PMID41398673
PMCPMC12822353

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.