Association of the TyHGB index with incident stroke in middle-aged and older Chinese adults: a 10-year prospective cohort study

Stroke remains a leading cause of disability and death among middle-aged and older adults in China. We investigated the association between baseline triglyceride/high-density lipoprotein cholesterol-glucose-body mass index (TyHGB) and incident stroke in 6956 Chinese adults aged ≥ 40 years who were free of stroke at baseline and followed for 10 years in the Luzhou component of the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Cox proportional hazards models, restricted cubic spline analysis, and time-dependent receiver operating characteristic analysis were performed. During follow-up, 342 incident strokes occurred. In the fully adjusted model, the highest versus lowest TyHGB quartile was associated with higher incident stroke risk (HR = 1.843, 95% CI 1.289–2.636; P for trend = 0.003), and each 1-unit increase was associated with a 5.6% higher risk (HR = 1.056, 95% CI 1.015–1.100). Restricted cubic splines indicated a positive, approximately linear association (P for overall < 0.001; P for nonlinearity = 0.276). Stand-alone discrimination was modest but slightly higher for TyHGB than TyG or BMI (AUC 0.598 vs 0.559 and 0.560). TyHGB may provide complementary metabolic information for stroke risk assessment.