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Published in: Cardiovascular Diabetology 1/2024

Open Access 01-12-2024 | Stroke | Research

Association between triglyceride-glucose index and intracranial/extracranial atherosclerotic stenosis: findings from a retrospective study

Authors: Yu Xie, Kuan Cen, Bitang Dan, Li Zou, Lei Zhang, Renwei Zhang, Huagang Li, Qi Cai, Nadire Aiziretiaili, Zhenxing Liu, Yumin Liu

Published in: Cardiovascular Diabetology | Issue 1/2024

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Abstract

Objective

The association of the triglyceride-glucose (TyG) index with intracranial atherosclerotic stenosis (ICAS) and extracranial atherosclerotic stenosis (ECAS) is unclear. This study aimed to investigate the relationship of TyG index with the distribution and severity of ICAS and ECAS.

Method

Patients who underwent digital subtraction angiography (DSA) for evaluating ICAS/ECAS in Zhongnan Hospital of Wuhan University from January 2017 to October 2021 were retrospectively enrolled in our study. Clinical characteristics, DSA data, blood routine, lipid profile and fasting glucose were recorded. The association of TyG index and ICAS/ECAS status were investigated in four aspects: location and distribution of stenosis, stenosis severity and whether stenosis is symptomatic. Logistic regression models were used to evaluate the association. Restricted cubic splines were constructed to model the non-linear relationship between the TyG index and different arterial stenosis status.

Results

Among 1129 included patients, the median age was 62 (IQR 55–68) years, and 71.3% were male. The median TyG index was 8.81 (8.40, 9.21). Elevated TyG index was significantly associated with ICAS, combined ICAS/ECAS, anterior circulation stenosis, posterior circulation stenosis, combined anterior/posterior circulation stenosis, severe stenosis, both asymptomatic and symptomatic stenosis. This association was maintained after adjusting for age, sex, smoking, drinking, medical history of hypertension and stroke, platelet, total cholesterol, high-density lipoprotein, and low-density lipoprotein. Multivariable-adjusted spline regression models showed that a progressively increasing risk of arterial stenosis was related to an elevated TyG index.

Conclusion

Elevated TyG index was associated with ICAS/ECAS. TyG index might be a useful indicator of ICAS and severe stenosis.
Literature
1.
go back to reference Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease Stroke Statistics—2021 Update Circulation. 2021;143(8):e254–743.PubMed Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease Stroke Statistics—2021 Update Circulation. 2021;143(8):e254–743.PubMed
2.
go back to reference Holmstedt CA, Turan TN, Chimowitz MI. Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment. Lancet Neurol. 2013;12(11):1106–14.CrossRefPubMedPubMedCentral Holmstedt CA, Turan TN, Chimowitz MI. Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment. Lancet Neurol. 2013;12(11):1106–14.CrossRefPubMedPubMedCentral
3.
go back to reference Sun J, Yuan C, Hatsukami TS. Stroke Prevention with Extracranial Carotid Artery Disease. Curr Cardiol Rep. 2021;23(11):161.CrossRefPubMed Sun J, Yuan C, Hatsukami TS. Stroke Prevention with Extracranial Carotid Artery Disease. Curr Cardiol Rep. 2021;23(11):161.CrossRefPubMed
4.
go back to reference Zhang Q, Xiao S, Jiao X, Shen Y. The triglyceride-glucose index is a predictor for cardiovascular and all-cause mortality in CVD patients with diabetes or pre-diabetes: evidence from NHANES 2001–2018. Cardiovasc Diabetol. 2023;22(1):279.CrossRefPubMedPubMedCentral Zhang Q, Xiao S, Jiao X, Shen Y. The triglyceride-glucose index is a predictor for cardiovascular and all-cause mortality in CVD patients with diabetes or pre-diabetes: evidence from NHANES 2001–2018. Cardiovasc Diabetol. 2023;22(1):279.CrossRefPubMedPubMedCentral
5.
go back to reference Wang J, Huang X, Fu C, Sheng Q, Liu P. Association between triglyceride glucose index, coronary artery calcification and multivessel coronary disease in Chinese patients with acute coronary syndrome. Cardiovasc Diabetol. 2022;21(1):187.CrossRefPubMedPubMedCentral Wang J, Huang X, Fu C, Sheng Q, Liu P. Association between triglyceride glucose index, coronary artery calcification and multivessel coronary disease in Chinese patients with acute coronary syndrome. Cardiovasc Diabetol. 2022;21(1):187.CrossRefPubMedPubMedCentral
6.
go back to reference Zhao Y, Sun H, Zhang W, Xi Y, Shi X, Yang Y, et al. Elevated triglyceride-glucose index predicts risk of incident ischaemic stroke: the rural Chinese cohort study. Diabetes Metab. 2021;47(4):101246.CrossRefPubMed Zhao Y, Sun H, Zhang W, Xi Y, Shi X, Yang Y, et al. Elevated triglyceride-glucose index predicts risk of incident ischaemic stroke: the rural Chinese cohort study. Diabetes Metab. 2021;47(4):101246.CrossRefPubMed
7.
go back to reference Cai W, Xu J, Wu X, Chen Z, Zeng L, Song X, et al. Association between triglyceride-glucose index and all-cause mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database. Cardiovasc Diabetol. 2023;22(1):138.CrossRefPubMedPubMedCentral Cai W, Xu J, Wu X, Chen Z, Zeng L, Song X, et al. Association between triglyceride-glucose index and all-cause mortality in critically ill patients with ischemic stroke: analysis of the MIMIC-IV database. Cardiovasc Diabetol. 2023;22(1):138.CrossRefPubMedPubMedCentral
8.
go back to reference Wang M, Mei L, Jin A, Cai X, Jing J, Wang S, et al. Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study. Cardiovasc Diabetol. 2022;21(1):204.CrossRefPubMedPubMedCentral Wang M, Mei L, Jin A, Cai X, Jing J, Wang S, et al. Association between triglyceride glucose index and atherosclerotic plaques and Burden: findings from a community-based study. Cardiovasc Diabetol. 2022;21(1):204.CrossRefPubMedPubMedCentral
9.
go back to reference Ding X, Li C, Yu K, Gao A, Xiao L, Peng F, et al. Different risk factors between intracranial and extracranial atherosclerotic stenosis in Asian population: a systematic review and meta-analysis. Int J Neurosci. 2014;124(11):834–40.CrossRefPubMed Ding X, Li C, Yu K, Gao A, Xiao L, Peng F, et al. Different risk factors between intracranial and extracranial atherosclerotic stenosis in Asian population: a systematic review and meta-analysis. Int J Neurosci. 2014;124(11):834–40.CrossRefPubMed
10.
go back to reference Kim JS, Nah HW, Park SM, Kim SK, Cho KH, Lee J, et al. Risk factors and stroke mechanisms in atherosclerotic stroke. Stroke. 2012;43(12):3313–8.CrossRefPubMed Kim JS, Nah HW, Park SM, Kim SK, Cho KH, Lee J, et al. Risk factors and stroke mechanisms in atherosclerotic stroke. Stroke. 2012;43(12):3313–8.CrossRefPubMed
11.
go back to reference Xie Y, Liu Z, Dan B, Zou L, Zhang L, Zhang R, et al. Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis. Front Neurol. 2022;13:966022.CrossRefPubMedPubMedCentral Xie Y, Liu Z, Dan B, Zou L, Zhang L, Zhang R, et al. Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis. Front Neurol. 2022;13:966022.CrossRefPubMedPubMedCentral
12.
go back to reference Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347–51.CrossRefPubMed Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347–51.CrossRefPubMed
13.
go back to reference Samuels OB, Joseph GJ, Lynn MJ, Smith HA, Chimowitz MI. A standardized method for measuring intracranial arterial stenosis. Am J Neuroradiol. 2000;21(4):643–6.PubMedPubMedCentral Samuels OB, Joseph GJ, Lynn MJ, Smith HA, Chimowitz MI. A standardized method for measuring intracranial arterial stenosis. Am J Neuroradiol. 2000;21(4):643–6.PubMedPubMedCentral
14.
go back to reference Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, American Heart Association/American Stroke Association Stroke Council. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the ; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009;40(6):2276–93. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, American Heart Association/American Stroke Association Stroke Council. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the ; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009;40(6):2276–93.
15.
go back to reference Zhao Q, Cheng YJ, Xu YK, Zhao ZW, Liu C, Sun TN, et al. Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus. Cardiovasc Diabetol. 2021;20:190.CrossRefPubMedPubMedCentral Zhao Q, Cheng YJ, Xu YK, Zhao ZW, Liu C, Sun TN, et al. Comparison of various insulin resistance surrogates on prognostic prediction and stratification following percutaneous coronary intervention in patients with and without type 2 diabetes mellitus. Cardiovasc Diabetol. 2021;20:190.CrossRefPubMedPubMedCentral
16.
go back to reference Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med. 2020;18(1):361.CrossRefPubMedPubMedCentral Hong S, Han K, Park CY. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med. 2020;18(1):361.CrossRefPubMedPubMedCentral
17.
go back to reference Wan Y, Zhang Z, Ling Y, Cui H, Tao Z, Pei J, et al. Association of triglyceride-glucose index with cardiovascular disease among a general population: a prospective cohort study. Diabetol Metab Syndr. 2023;15(1):204.CrossRefPubMedPubMedCentral Wan Y, Zhang Z, Ling Y, Cui H, Tao Z, Pei J, et al. Association of triglyceride-glucose index with cardiovascular disease among a general population: a prospective cohort study. Diabetol Metab Syndr. 2023;15(1):204.CrossRefPubMedPubMedCentral
18.
go back to reference Shali S, Luo L, Yao K, Sun X, Wu H, Zhang S, et al. Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults. Cardiovasc Diabetol. 2023;22(1):283.CrossRefPubMedPubMedCentral Shali S, Luo L, Yao K, Sun X, Wu H, Zhang S, et al. Triglyceride-glucose index is associated with severe obstructive coronary artery disease and atherosclerotic target lesion failure among young adults. Cardiovasc Diabetol. 2023;22(1):283.CrossRefPubMedPubMedCentral
19.
go back to reference Wang Y, Liu T, Li Y, Zhang K, Fan H, Ren J, et al. Triglyceride-glucose index, symptomatic intracranial artery stenosis and recurrence risk in minor stroke patients with hypertension. Cardiovasc Diabetol. 2023;22(1):90.CrossRefPubMedPubMedCentral Wang Y, Liu T, Li Y, Zhang K, Fan H, Ren J, et al. Triglyceride-glucose index, symptomatic intracranial artery stenosis and recurrence risk in minor stroke patients with hypertension. Cardiovasc Diabetol. 2023;22(1):90.CrossRefPubMedPubMedCentral
20.
go back to reference Wu Y, Yang Y, Zhang J, Liu S, Zhuang W. The change of triglyceride-glucose index may predict incidence of stroke in the general population over 45 years old. Cardiovasc Diabetol. 2023;22(1):132.CrossRefPubMedPubMedCentral Wu Y, Yang Y, Zhang J, Liu S, Zhuang W. The change of triglyceride-glucose index may predict incidence of stroke in the general population over 45 years old. Cardiovasc Diabetol. 2023;22(1):132.CrossRefPubMedPubMedCentral
21.
go back to reference López-Cancio E, Galán A, Dorado L, Jiménez M, Hernández M, Millán M, et al. Biological signatures of asymptomatic extra- and intracranial atherosclerosis: the Barcelona-AsIA (asymptomatic intracranial atherosclerosis) study. Stroke. 2012;43(10):2712–9.CrossRefPubMed López-Cancio E, Galán A, Dorado L, Jiménez M, Hernández M, Millán M, et al. Biological signatures of asymptomatic extra- and intracranial atherosclerosis: the Barcelona-AsIA (asymptomatic intracranial atherosclerosis) study. Stroke. 2012;43(10):2712–9.CrossRefPubMed
22.
go back to reference Wang A, Tian X, Zuo Y, Chen S, Zhang X, Guo J, et al. Association of triglyceride-glucose index with intra- and extra-cranial arterial stenosis: a combined cross-sectional and longitudinal analysis. Endocrine. 2021;74(2):308–17.CrossRefPubMed Wang A, Tian X, Zuo Y, Chen S, Zhang X, Guo J, et al. Association of triglyceride-glucose index with intra- and extra-cranial arterial stenosis: a combined cross-sectional and longitudinal analysis. Endocrine. 2021;74(2):308–17.CrossRefPubMed
23.
go back to reference D’Armiento FP, Bianchi A, de Nigris F, Capuzzi DM, D’Armiento MR, Crimi G, et al. Age-related effects on atherogenesis and scavenger enzymes of intracranial and extracranial arteries in men without classic risk factors for atherosclerosis. Stroke. 2001;32(11):2472–9.CrossRefPubMed D’Armiento FP, Bianchi A, de Nigris F, Capuzzi DM, D’Armiento MR, Crimi G, et al. Age-related effects on atherogenesis and scavenger enzymes of intracranial and extracranial arteries in men without classic risk factors for atherosclerosis. Stroke. 2001;32(11):2472–9.CrossRefPubMed
24.
go back to reference Wang Q, Zhao Y, Wang X, Ji X, Sang S, Shao S, et al. Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China. BMJ Open Diabetes Res Care. 2020;8(2):e001788.CrossRefPubMedPubMedCentral Wang Q, Zhao Y, Wang X, Ji X, Sang S, Shao S, et al. Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China. BMJ Open Diabetes Res Care. 2020;8(2):e001788.CrossRefPubMedPubMedCentral
25.
go back to reference Luo Y, Li Z, Zhang J, Li J, Lu Z. Dyslipidaemia was correlated to the posterior circulation infarction in non-diabetic populations. Lipids Health Dis. 2018;17(1):150.CrossRefPubMedPubMedCentral Luo Y, Li Z, Zhang J, Li J, Lu Z. Dyslipidaemia was correlated to the posterior circulation infarction in non-diabetic populations. Lipids Health Dis. 2018;17(1):150.CrossRefPubMedPubMedCentral
26.
go back to reference Subramanian G, Silva J, Silver FL, Fang J, Kapral MK, Oczkowski W, et al. Risk factors for posterior compared to anterior ischemic stroke: an observational study of the Registry of the Canadian Stroke Network. Neuroepidemiology. 2009;33(1):12–6.CrossRefPubMed Subramanian G, Silva J, Silver FL, Fang J, Kapral MK, Oczkowski W, et al. Risk factors for posterior compared to anterior ischemic stroke: an observational study of the Registry of the Canadian Stroke Network. Neuroepidemiology. 2009;33(1):12–6.CrossRefPubMed
Metadata
Title
Association between triglyceride-glucose index and intracranial/extracranial atherosclerotic stenosis: findings from a retrospective study
Authors
Yu Xie
Kuan Cen
Bitang Dan
Li Zou
Lei Zhang
Renwei Zhang
Huagang Li
Qi Cai
Nadire Aiziretiaili
Zhenxing Liu
Yumin Liu
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Stroke
Published in
Cardiovascular Diabetology / Issue 1/2024
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-024-02187-1

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