Association between cumulative changes of the triglyceride glucose index and incidence of Cardio-cerebral vascular diseases in a population with cardiovascular-kidney-metabolic syndrome stage 0-3: a nationwide prospective cohort study.

OBJECTIVE

To evaluate the relationship between the longitudinal changes of the triglyceride-glucose (TyG) index and the incidence of cardio-cerebral vascular diseases (CCVD) among individuals with CKM syndrome stages 0-3.

METHODS

Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), this longitudinal study included 3,416 participants aged 45 and above. Participants were categorized into different TyG trajectory groups using k-means clustering analysis. Logistic regression and restricted cubic spline (RCS) models were employed to assess the associations between cumTyG and TyG changes with CCVD incidence.

RESULTS

Over a median follow-up of 5 years, 698 participants developed CCVD. The relationship between cumTyG and CCVD risk was linear in RCS regression. After adjusting for potential confounders, the risk of CCVD was found to be significantly higher for participants in Class 2, Class 4, and Class 5 compared to those in Class 1. Specifically, Class 2 had an odds ratio (OR) of 1.45 (95% confidence interval [CI]: 1.14, 1.84), Class 4 had an OR of 1.42 (95% CI: 1.09, 1.86), and Class 5 had an OR of 1.64 (95% CI: 1.14, 2.34). Additionally, an elevated cumTyG index was associated with an increased risk of CCVD, with an OR of 1.13 (95% CI: 1.05, 1.22, P=0.002).

CONCLUSION

CumTyG and its longitudinal trend are independent and potent predictors of CCVD in patients with stage 1-3 CKM syndrome. Dynamic monitoring of the TyG trajectory can enable the early identification of high-risk individuals, providing reliable evidence for individualized and cost-effective prevention.