Baseline, cumulative, and short-term changes in triglyceride-glucose-related obesity indices and incident cardiovascular disease in middle-aged and older Chinese adults: a prospective national cohort study.

Abstract

Background and aim: The triglyceride-glucose (TyG) index combined with obesity indices (TyG-OIs) predicts the risk of cardiovascular disease (CVD). However, evidence regarding the cumulative exposure to TyG and TyG-OIs, their short-term changes, and their associations with CVD remains limited. This study aims to address these gaps.

Methods and results: Using data from the China Health and Retirement Longitudinal Study (CHARLS), which included 2510 participants and 340 incident CVD cases, we calculated seven indices-TyG alone and six TyG-related obesity indices (TyG-OIs)-at baseline (2011-2012) and at Wave 3 (2015). We assessed cumulative exposure using the area under the curve and evaluated short-term changes through K-means clustering. Logistic regression analysis was performed to examine associations. Baseline TyG-WC, TyG-WHtR, TyG-ABSI, and TyG-WWI were significantly associated with CVD. Cumulative exposure to all indices except TyG-BMI showed positive associations, with TyG-WHtR demonstrating the strongest effects (Q2 OR = 1.73, Q3 OR = 1.95, Q4 OR = 1.81). Short-term changes in TyG, TyG-WC, TyG-BMI, TyG-ABSI, and TyG-WWI remained significant. TyG-WC, TyG-ABSI, and TyG-WWI were consistently associated with CVD across all three exposure metrics.

Conclusion: The association between TyG and TyG-OIs with CVD risk varies depending on the exposure metric used. TyG-WC, TyG-ABSI, and TyG-WWI consistently predict CVD risk across baseline, cumulative, and short-term measures. Repeated monitoring of fasting glucose, triglycerides, waist circumference, ABSI, and WWI may improve long-term CVD risk assessment.