Supplementary Material for: Association between Triglyceride-Glucose Index and 1-year Recurrent Stroke after Acute Ischemic Stroke: Results from the Xi’an Stroke Registry Study of China

Introduction: The triglyceride-glucose (TyG) index is reported to be related to poor functional outcomes and all-cause mortality post-stroke. However, the association between TyG index and recurrent stroke after acute ischemic stroke (AIS) has not been well described. We aimed to identify whether the TyG index was associated with 1-year recurrent stroke after AIS. Methods: Baseline patient information was collected at admission, and the TyG index was calculated. Recurrent stroke events were followed up at 1, 3, 6, and 12 months after diagnosis. We then examined the association between the TyG index and risk of 1-year recurrent stroke using multivariable Cox regression models and restricted cubic spline analyses. Results: Among 2,288 participants, the mean TyG index was 8.8  0.7. Those in the fourth quartile (Q4) demonstrated higher recurrent stroke risk than those in Q1 (adjusted hazard ratio [HR] = 1.63; 95% confidence interval [CI], 0.98–2.72; p = 0.059). Subgroup analysis revealed a sex-specific association between TyG index and recurrent stroke (p for interaction = 0.022). Additionally, restricted cubic splines analyses showed a non-linear association between the TyG index and 1-year recurrent stroke. In females, patients in the Q4 had a 2.95-fold increased recurrent stroke risk than did patients in the Q1 (adjusted HR =2.95; 95% CI, 1.09–7.94; p = 0.032); the risk increased when the TyG index was > 8.73. However, no significant correlation was observed in males. Conclusion: A non-linear association was found between the TyG index and 1-year recurrent stroke risk. Subsequently, a high TyG index could predict an increased 1-year recurrent stroke risk in female AIS patients.

引言：已有研究表明，甘油三酯-葡萄糖（TyG）指数与脑卒中后不良功能结局及全因死亡率相关。然而，目前关于急性缺血性脑卒中（AIS）患者的TyG指数与复发性脑卒中之间的关联尚缺乏充分阐述。本研究旨在明确急性缺血性脑卒中患者的TyG指数是否与其1年内复发性脑卒中风险相关。方法：收集患者入院时的基线信息，并计算其TyG指数。于确诊后1、3、6及12个月对患者进行随访，记录复发性脑卒中事件。随后采用多因素Cox回归模型及限制性立方样条分析，探究TyG指数与1年复发性脑卒中风险之间的关联。结果：本研究共纳入2288名受试者，其平均TyG指数为8.8±0.7。与四分位组1（Q1）受试者相比，四分位组4（Q4）受试者的复发性脑卒中风险更高（校正后风险比[HR]=1.63；95%置信区间[CI]：0.98~2.72；P=0.059）。亚组分析显示，TyG指数与复发性脑卒中的关联存在性别差异（交互作用P=0.022）。此外，限制性立方样条分析结果表明，TyG指数与1年复发性脑卒中风险之间存在非线性关联。在女性受试者中，Q4组患者的复发性脑卒中风险较Q1组升高2.95倍（校正后HR=2.95；95%CI：1.09~7.94；P=0.032）；当TyG指数＞8.73时，该风险进一步升高。而在男性受试者中未观察到显著相关性。结论：本研究发现TyG指数与1年复发性脑卒中风险之间存在非线性关联，较高的TyG指数可预测女性急性缺血性脑卒中患者1年内复发性脑卒中风险升高。