Maturitas · 2026
Combined associations of triglyceride-glucose index and biochemical sarcopenia index with cardiometabolic multimorbidity in middle-aged and older Chinese adults.
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Chen Yan, Chen Jun, Meng Zijia, Gao Jing, Feng Xiaodong
Аннотация
BACKGROUND: Cardiometabolic multimorbidity confers a substantial disease burden in middle-aged and older adults. The triglyceride-glucose index is a reliable marker of insulin resistance, while the biochemical sarcopenia index reflects skeletal muscle mass. However, their combined association with cardiometabolic multimorbidity remains unclear.
METHODS: Based on the China Health and Retirement Longitudinal Study prospective cohort, we included 6092 participants aged ≥45 years. Cox regression, restricted cubic spline, time-dependent receiver operating characteristic curves, and interaction analyses were performed to examine the associations of triglyceride-glucose index, biochemical sarcopenia index, and a composite index with incident cardiometabolic multimorbidity, as well as predictive performance and effect modification.
RESULTS: During a mean 9.27-year follow-up, there were 652 incident cases of cardiometabolic multimorbidity. The triglyceride-glucose index and composite index were independently associated with a higher risk of cardiometabolic multimorbidity (both P < 0.001), whereas the biochemical sarcopenia index showed no longitudinal predictive value after full adjustment. No significant additive or multiplicative interaction was observed between the TyG index and SI (RERI = 0.005, 95% CI -0.512 to 0.522; AP = 0.003, 95% CI -0.270 to 0.275; S = 1.006, 95% CI 0.892 to 1.134). Predictive performance of all indices gradually declined with longer follow-up.
CONCLUSION: The triglyceride-glucose index is a robust and independent predictor of incident cardiometabolic multimorbidity. A composite index derived from a principal component analysis showed a very small incremental improvement over the TyG index alone (ΔAUC = 0.006), though the clinical significance of this difference is uncertain and requires external validation.
METHODS: Based on the China Health and Retirement Longitudinal Study prospective cohort, we included 6092 participants aged ≥45 years. Cox regression, restricted cubic spline, time-dependent receiver operating characteristic curves, and interaction analyses were performed to examine the associations of triglyceride-glucose index, biochemical sarcopenia index, and a composite index with incident cardiometabolic multimorbidity, as well as predictive performance and effect modification.
RESULTS: During a mean 9.27-year follow-up, there were 652 incident cases of cardiometabolic multimorbidity. The triglyceride-glucose index and composite index were independently associated with a higher risk of cardiometabolic multimorbidity (both P < 0.001), whereas the biochemical sarcopenia index showed no longitudinal predictive value after full adjustment. No significant additive or multiplicative interaction was observed between the TyG index and SI (RERI = 0.005, 95% CI -0.512 to 0.522; AP = 0.003, 95% CI -0.270 to 0.275; S = 1.006, 95% CI 0.892 to 1.134). Predictive performance of all indices gradually declined with longer follow-up.
CONCLUSION: The triglyceride-glucose index is a robust and independent predictor of incident cardiometabolic multimorbidity. A composite index derived from a principal component analysis showed a very small incremental improvement over the TyG index alone (ΔAUC = 0.006), though the clinical significance of this difference is uncertain and requires external validation.