ORIGINAL RESEARCH article
Front. Med.
Sec. Family Medicine and Primary Care
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1616520
This article is part of the Research TopicIntegrated primary care for post-stroke patients to improve long-term outcomes through multidisciplinary collaborationView all 3 articles
Unraveling the Role of Cumulative Triglyceride-Total Cholesterol-Body Weight Index (TCBI) in Stroke Development: Evidence from the CHARLS Cohort
Provisionally accepted
- Suining Central Hospital, Suining, China
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Background: This study investigated the association between the cumulative triglyceride-total cholesterol-body weight index (TCBI) and the risk of stroke among middle-aged and older adults, focusing on hypertension as a potential mediator. Methods: Data from 5,598 participants aged ≥45 years in the China Health and Retirement Longitudinal Study were analyzed over a median follow-up of 57.2 months. CumTCBI was calculated as ((TCBI( 2011)+TCBI( 2015))/2)×(2015 -2011). The risk of stroke was the primary outcome. Cox proportional hazards models and restricted cubic splines were used to examine the association between CumTCBI and stroke risk. Mediation analysis investigated the role of hypertension as a potential mediator of the association between CumTCBI and stroke risk.Results: During the follow-up period, 480 (8.93%) participants experienced stroke.The fully adjusted CumTCBI was significantly associated with stroke (HR per 1 SD = 1.166). A non-linearly association was observed, with stroke risk increasing when CumTCBI was below 12.639 (HR per 100 units = 1.166, P=0.002) and remaining stable beyond this threshold (P=0.356). Additionally, hypertension mediated 27.4% of the association. Conclusion: CumTCBI is non-linearly associated with stroke risk, partially mediated by hypertension. Managing both metabolic status and hyperternsion may reduce stroke risk in aging populations.
Keywords: TCBI, Stroke, non-linearly relationship, Mediation analysis, CHARLS
Received: 23 Apr 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Luwen, Yunwei, Lei, Linlin and Ming. 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: Yu Ming, Suining Central Hospital, Suining, China
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