Exploring the Dynamics of Triglyceride With Stroke Onset in the Chinese Population Through Parameterized Joint Models

Abstract Background: Stroke has become one of the diseases with the highest mortality and disability rates in the world, especially in low-income and developing countries. Our objective was to discuss the relationship between the longitudinal dynamic changes of TG and stroke onset in healthy population by constructing different parametric joint models.Methods: 298 participants aged 23 to 69 in Xijing hospital of Xi’an City in Shanxi Province from 2008 to 2015 were included. The Cox proportional hazards model was performed to analyze the correlation between TG and stroke incidence at baseline. Different parameterized joint models were used to analyze the impact of dynamic changes of TG on the incidence of stroke under longitudinal data.Results: Of the 298 participants, a total of 70 (23.49%) subjects developed stroke during the study period. Cox proportional hazards model showed that the risk of disease increased by 1.056 times (95%CI=0.920-0.975) for each 1 unit of baseline age decrease. Each 1 mmol/L increase in sqrt(TG) increased the risk by 1.816 times (95%CI=1.017-3.245). Joint model showed that the risk of sqrt (TG) increased by 4.869 times (95%CI=3.987-8.857) for each 1 mmol/L increase in longitudinal direction.The lagged effects (HR=5.284, 95%CI=4.397-9.680) and cumulative effects (HR=1.786, 95%CI=1.613-3.399) of sqrt (TG) dynamic trajectory were also statistically related to the incidence of stroke.Conclusions: Over time, the longitudinal growth of TG levels in individuals will increase the risk of stroke even more. People should pay more attention to the dynamic changes of individual TG value, as well as the lagged effect and cumulative effect, to reduce the incidence of stroke.