Abstract Body: Background: A high triglyceride-glucose (TyG) index is a reliable proxy for insulin resistance and also a significant predictor of poor outcomes, stroke recurrence, and neurological worsening in patients with acute ischemic stroke and other cerebrovascular diseases, conditions that can involve seizures. This study aimed to investigate whether the TyG index independently predicts the risk of epilepsy and seizures in a large cohort of postmenopausal women.
Methods: This study consisted of 25,491 postmenopausal women without a history of previous seizure or epilepsy, followed from 2002 to 2021. Participants were categorized into tertiles (T1–T3) based on their TyG index. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Model 1 was adjusted for age, and Model 2 was further adjusted for lifestyle factors (smoking, alcohol consumption, and physical exercise).
Results: A significant positive trend was observed between the TyG index and the incidence of epilepsy. In Model 1 (age-adjusted), the highest TyG index tertiles (T3) showed a 14% increased risk of epilepsy compared to the lowest tertiles (T1) (P for trend = 0.0478). This association remained significant in Model 2 after adjusting for lifestyle variables (HR 1.14; 95% CI 1.00–1.29; P for trend = 0.0480). In contrast, there was no statistically significant association between the TyG index and the incidence of seizures across all models.
Conclusion: Over a 20-year follow-up period, a higher TyG index was identified as an independent predictor of epilepsy—characterized by repeated, unprovoked seizures—rather than isolated seizure events in postmenopausal women. These findings suggest that chronic insulin resistance may contribute to the long-term development of clinical epilepsy.