Triglyceride-glucose (TyG) index combined with C-reactive protein outperforms the TyG index alone in predicting stroke in arthritis patients: a nationwide prospective cohort study.
Arthritis patients exhibit a higher stroke risk, but effective predictive biomarkers are scarce. This research sought to examine and compare the associations between the triglyceride-glucose (TyG) index, its integration with C-reactive protein (CRP) (TyG-CRP), and stroke risk in these patients.
This research examined data from 3,419 arthritis patients participating in the China Health and Retirement Longitudinal Study (CHARLS), focusing on the occurrence of new stroke events as the main outcome. Examination of the association between the TyG index, TyG-CRP and stroke risk relied on Kaplan-Meier, Cox regression, and restricted cubic splines (RCS) analyses.
During the 9-year follow-up period, 339 arthritis patients (9.9%) had their initial stroke. Stroke incidence increased steadily from the lowest to highest tertile categories as determined by both TyG index and TyG-CRP (P < 0.05). After full covariate adjustment, each 1-unit increment in TyG-CRP raised stroke risk by 18% (HR, 1.18; 95% CI, 1.01-1.39), and individuals in the top TyG-CRP tertile were 1.4 times more likely to experience a stroke versus those in the bottom tertile (HR, 1.40; 95% CI, 1.03-1.92). There was no significant link between the TyG index and stroke risk, whether it was assessed continuously or by tertiles (P > 0.05) in the fully adjusted models. TyG-CRP was significantly linearly related to stroke incidence (P-overall: 0.047; P-nonlinear: 0.725), whereas the TyG index, although linear, also demonstrated an insignificance (P-overall: 0.165; P-nonlinear: 0.557). In sensitivity analyses conducted among complete cases, TyG-CRP demonstrated borderline statistical significance for stroke risk in the model with comprehensive covariate adjustment (P = 0.058 for the continuous variable analysis; P = 0.064 for tertile-based comparisons).
TyG-CRP is a standalone predictor of stroke in arthritis individuals, whereas the TyG index does not significantly predict stroke risk.
This research examined data from 3,419 arthritis patients participating in the China Health and Retirement Longitudinal Study (CHARLS), focusing on the occurrence of new stroke events as the main outcome. Examination of the association between the TyG index, TyG-CRP and stroke risk relied on Kaplan-Meier, Cox regression, and restricted cubic splines (RCS) analyses.
During the 9-year follow-up period, 339 arthritis patients (9.9%) had their initial stroke. Stroke incidence increased steadily from the lowest to highest tertile categories as determined by both TyG index and TyG-CRP (P < 0.05). After full covariate adjustment, each 1-unit increment in TyG-CRP raised stroke risk by 18% (HR, 1.18; 95% CI, 1.01-1.39), and individuals in the top TyG-CRP tertile were 1.4 times more likely to experience a stroke versus those in the bottom tertile (HR, 1.40; 95% CI, 1.03-1.92). There was no significant link between the TyG index and stroke risk, whether it was assessed continuously or by tertiles (P > 0.05) in the fully adjusted models. TyG-CRP was significantly linearly related to stroke incidence (P-overall: 0.047; P-nonlinear: 0.725), whereas the TyG index, although linear, also demonstrated an insignificance (P-overall: 0.165; P-nonlinear: 0.557). In sensitivity analyses conducted among complete cases, TyG-CRP demonstrated borderline statistical significance for stroke risk in the model with comprehensive covariate adjustment (P = 0.058 for the continuous variable analysis; P = 0.064 for tertile-based comparisons).
TyG-CRP is a standalone predictor of stroke in arthritis individuals, whereas the TyG index does not significantly predict stroke risk.