IGF1 and ischemic stroke: Ischemic stroke is the most important source of vascular dementia (VD) (54), and the TyG index is likely to affect cerebral vascular reserve by interfering with insulin signaling, enhancing chronic systemic inflammation, increasing the formation of foam cells, and affecting the metabolism of insulin-like growth factors (IGF-1 and IGF-2), cyclic guanosine monophosphate (cGMP), and nitric oxide (NO), thereby further leading to a decline in cognitive.