Exploring the Association Between the TyG-WHtR Index and the Incidence of Stroke in the Obese Population: based on NHANES data from 1998-2018

Background: The TyG index is an emerging low-cost and efficient indicator that is significantly associated with stroke. Multiple studies have confirmed the impact of the TyG index on cerebrovascular diseases. However, the role of indices combining TyG with different obesity factors, such as triglyceride glucose-waist-height ratio (TyG-WHtR) on stroke risk in obese individuals remains unclear. This study utilizes data from the National Health and Nutrition Examination Survey database between 1998 and 2018 to explore the relationship between stroke and the TyG-WHtR index in obese individuals.

Methods: This cross-sectional study analyzed data from 5767 obese individuals from the NHANES database between 1998 and 2018. Univariate and multivariate logistic regression analyses were used to study the association between TyG-WHtR and stroke, utilizing continuous variables or categorizing variables based on quartiles. Propensity score matching (PSM) and subgroup analysis stratifying characteristics of TyG-WHtR and stroke were further conducted to study their relationship. Additionally, restricted cubic spline (RCS) analysis was performed to examine the linear relationship between TyG-WHtR and stroke.

Results: A total of 5767 participants were included in the statistical analysis, comprising 227 stroke patients and 5540 non-stroke participants. Multivariable logistic regression analysis revealed a positive association between TyG-WHtR and stroke both before and after matching (P<0.001), with statistically significant differences. Subgroup analysis indicated a statistically significant difference among non-Hispanic white individuals, and RCS analysis showed a non-linear relationship between TyG-WHtR and stroke before matching, but a linear relationship after matching.

Conclusion: In obese individuals, a higher TyG-WHtR index is positively associated with stroke risk.