ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1663393
This article is part of the Research TopicNew horizons in stroke management: Volume IIView all 4 articles
Elevated TyG-BMI significantly increases the 1-year stroke recurrence risk in patients with acute ischemic stroke and hypertension
Provisionally accepted
Yan Liu
Zhongzhong Liu
Qingli Lu
Pei LiuMi ZhangQiaoqiao ChangTong Liu
Linna PengLanping RaoChao SunGuo LiShundao Cao
Xuemei Lin*
Songdi Wu*- Xi'an No.1 Hospital, Xi'an, China
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Abstract Objectives: To investigate the association between triglyceride-glucose-body mass index (TyG-BMI) and the 1-year stroke recurrence risk in patients with acute ischemic stroke (AIS) and hypertension. Methods: In this retrospective, multicenter cohort study, multivariable Cox proportional hazards models were constructed, and curve fitting and subgroup analyses were performed to evaluate the aforementioned association. TyG-BMI was analyzed as a continuous variable and in quartiles (Q1–Q4). Sex-specific stratified analyses were performed to explore potential effect modifications. Results: Among 1,620 enrolled patients (39.6% women; mean age 65.2±11.5 years), elevated TyG-BMI was significantly associated with increased 1-year stroke recurrence risk after adjusting for potential confounding factors (hazard ratio [HR]=1.06, 95% confidence interval [CI]: 1.01–1.11, P=0.032). This association was particularly prominent in women (HR=1.18, 95%CI: 1.07–1.29, P<0.001). Women in the Q3 and Q4 TyG-BMI groups had significantly higher 1-year stroke recurrence risks (Q3: HR=8.81 95%CI: 2.22–34.97, P=0.002; Q4: HR=5.79 95%CI: 1.49–22.56, P=0.011) compared with those in the Q1 group. No significant association was observed in men (HR=1.01, 95%CI: 0.94–1.08, P=0.830). Segmented linear regression and curve fitting revealed a significant sex-specific nonlinear relationship between TyG-BMI and 1-year stroke recurrence risk. For women when TyG-BMI was below 221.97, each unit increase was associated with a more pronounced increase in the risk of 1-year stroke recurrence compared to patients above this threshold (adjusted HR = 1.04, 95% CI 1.01–1.07, P = 0.005). Conclusion: Elevated TyG-BMI is independently associated with a higher risk of 1-year stroke recurrence in patients with AIS and hypertension. A significant association was identified only in women, specifically among those with a TyG-BMI below 221.97, below which each unit increase in TyG-BMI was associated with a significantly greater risk of 1-year stroke recurrence compared to those above this threshold.
Keywords: ischemic stroke, TyG-BMI, Stroke recurrence, Hypertension, sex differences
Received: 30 Jul 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Liu, Liu, Lu, Liu, Zhang, Chang, Liu, Peng, Rao, Sun, Li, Cao, Lin and Wu. 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:
Xuemei Lin, xuemei_yilei@163.com
Songdi Wu, wusongdi@gmail.com
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