Long-term dual-trajectories of TyG and LAP and their association with cardiometabolic multimorbidity in midlife: the CARDIA study.

IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2025-05-09 DOI:10.1186/s12933-025-02761-1

Lingqu Zhou, Junjie Wang, Zirui Zhou, Liangjiao Wang, Qi Guo, Hui Zeng, Ziyue Zhong, Yinyin Zhang

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Abstract

Background: Insulin resistance and central obesity are major risk factors for cardiometabolic diseases. The triglyceride-glucose index (TyG) and lipid accumulation product (LAP) are markers that independently predict cardiometabolic risk. However, their combined long-term trajectories and impact on cardiometabolic multimorbidity (CMM) development remain unclear.

Methods: This cohort study utilized data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which tracked 3467 participants at baseline. Dual-trajectory of TyG and LAP were identified using a group-based dual-trajectory model. Cox proportional hazards models were employed to assess the relationships between dual-trajectory groups and primary cardiometabolic outcomes, including first cardiometabolic disease (FCMD), CMM (two or more conditions such as type 2 diabetes, coronary heart disease, or stroke), and all-cause mortality. Multi-state models were performed to assess the associations of dual-trajectory with CMM development.

Results: The study included 3467 participants with a mean age of 25.08 years (SD = 3.59). Of these, 43.4% (n = 1505) were male, and 53.2% (n = 1561) were White. Three distinct dual-trajectory groups were identified: low-increasing (61.5%), high-amplitude fluctuation (7.6%), and high-increasing (30.9%). After multivariate adjustment, compared with the low-increasing group, the high-amplitude fluctuation group exhibited significantly higher risks for FCMD (hazard ratio [HR] 1.38, 95% confidence interval [CI]: 1.08-1.77), CMM (HR 2.63, 95% CI 1.21-5.71), and all-cause mortality (HR 2.16, 95% CI 1.30-3.56), as well as elevated risks for transitions from baseline to FCMD (HR 1.41, 95% CI 1.17-1.63), FCMD to CMM (HR 2.07, 95% CI 1.53-3.96), CMM to death (HR 2.87, 95% CI 1.19-7.62). The high-increasing group showed similar results.

Conclusions: Elevated and fluctuating trajectories of TyG and LAP from early adulthood are associated with increased risks of CMM development in midlife.

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TyG和LAP的长期双轨迹及其与中年心脏代谢多病的关系：CARDIA研究

背景：胰岛素抵抗和中心性肥胖是心脏代谢疾病的主要危险因素。甘油三酯-葡萄糖指数（TyG）和脂质积累产物（LAP）是独立预测心脏代谢风险的标志物。然而，它们的综合长期轨迹和对心脏代谢多病（CMM）发展的影响仍不清楚。方法：这项队列研究利用了来自年轻人冠状动脉风险发展（CARDIA）研究的数据，该研究在基线时追踪了3467名参与者。采用基于分组的双轨迹模型确定TyG和LAP的双轨迹。采用Cox比例风险模型来评估双轨迹组与主要心脏代谢结局之间的关系，包括首次心脏代谢疾病（FCMD）、CMM（两种或两种以上疾病，如2型糖尿病、冠心病或中风）和全因死亡率。采用多状态模型来评估双轨迹与CMM发展的关系。结果：研究纳入3467名参与者，平均年龄25.08岁（SD = 3.59）。其中男性占43.4% (n = 1505)，白人占53.2% （n = 1561）。确定了三个不同的双轨迹组：低增长（61.5%），高幅度波动（7.6%）和高增长（30.9%）。多因素调整后，与低增加组相比，高幅度波动组出现FCMD（风险比[HR] 1.38, 95%可信区间[CI]: 1.08-1.77）、CMM（风险比2.63,95% CI 1.21-5.71）和全因死亡率（风险比2.16,95% CI 1.30-3.56）的风险显著升高，从基线到FCMD（风险比1.41,95% CI 1.17-1.63）、FCMD到CMM（风险比2.07,95% CI 1.53-3.96）、CMM到死亡（风险比2.87,95% CI 1.19-7.62）的风险也升高。高增长组也有类似的结果。结论：成年早期TyG和LAP的升高和波动轨迹与中年CMM发展的风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.