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.

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.