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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Lipids in Cardiovascular Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1429993

Triglyceride-glucose index mediates the association between residual cholesterol and stroke among middle-aged and older adults in China: a prospective, nationwide, population-based study

Provisionally accepted
Xu Li Xu Li 1Jiaguang Hu Jiaguang Hu 1Qian Liao Qian Liao 2Ying Wu Ying Wu 1*Rong-Rui Huo Rong-Rui Huo 2*
  • 1 Liuzhou People's Hospital, Liuzhou, Guangxi Zhuang Region, China
  • 2 Guangxi Medical University Cancer Hospital, Nanning, China

The final, formatted version of the article will be published soon.

    Background: Both triglyceride-glucose (TyG) index and residual cholesterol (RC) are predictors of stroke; however, to what extent the residual cholesterolRC is associated with stroke through TyG index is unclear. This study examined whether the TyG index mediates the association of residual cholesterolRC with incident stroke and the extent of interaction or joint relations of residual cholesterolRC and TyG index with stroke in middle-aged and older Chinese adults.Methods: This is an ongoing prospective cohort study initiated in 2011 that included 10 569 middle-aged and older Chinese adults without stroke at baseline. The exposure was residual cholesterolRC, the mediator was TyG index, and the outcome was stroke which followed up from June, 2011, to June, 2018. Mediation analysis was used to explore whether the TyG index mediated the association between residual cholesterolRC and stroke risk.Results: Of the 10 569 participants, 4 978 (47.1%) were men; the mean (SD) age was 59.01 (9.43) years. During a median follow-up of 7.1 years, 734 (7.0%) participants experienced a stroke. In the adjusted Cox models, A one SD increase in residual cholesterolRC was associated with an elevated risk of stroke (HR, 1.09; 95% CI, 1.02-1.16), as well as TyG index (HR, 1.14; 95% CI, 1.06-1.23). No significant multiplicative or additive interactions were found between the TyG index and residual cholesterolRC on stroke risk (HR for multiplicative: 1.07, 95% CI, 0.67-1.70; Synergy index: 1.05, 95% CI, 0.16-6.88). TyG index mediated the association between residual cholesterolRC and stroke (b, -0.16; 95% CI, -0.30 to -0.03). Subgroup analyses and sensitivity analyses showed consistent results.This study evidence that the TyG index completely mediates the association between residual cholesterolRC and stroke risk among middle-aged and older Chinese adults.These findings highlight the importance of considering both residual cholesterolRC and the TyG index in stroke risk assessment.

    Keywords: Stroke, Triglyceride-glucose index, Residual cholesterol, Insulin Resistance, CHARLS

    Received: 09 May 2024; Accepted: 21 Nov 2024.

    Copyright: © 2024 Li, Hu, Liao, Wu and Huo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ying Wu, Liuzhou People's Hospital, Liuzhou, Guangxi Zhuang Region, China
    Rong-Rui Huo, Guangxi Medical University Cancer Hospital, Nanning, China

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