ArticleCardiovascular diabetology2025
Joint effects of triglyceride glucose index and its obesity-related derivatives with estimated glucose disposal rate on cardiometabolic multimorbidity in middle-aged and older Chinese adults: a nationwide cohort study.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Long-term cumulative exposure and change patterns of CTI-FI predict the risk of cardiometabolic multimorbidity in middle-aged and older Chinese adults.Journal of diabetes and metabolic disorders · 2026Article
- Triglyceride-glucose waist-to-height ratio in relation to prevalent and incident multimorbidity: cross-sectional and prospective evidence from four national studies.Cardiovascular diabetology · 2026Article
- Cardiovascular-liver-metabolic multimorbidity: preliminary insights into the associations with the triglyceride glucose index (TyG), its obesity-derived indices and their effects on long-term survival.Cardiovascular diabetology · 2026Article
- Association between insulin resistance surrogate markers and cardiovascular disease risk in individuals with subclinical metabolic disorders: a prospective cohort study based on baseline levels, cumulative exposure, and longitudinal trajectories.Cardiovascular diabetology · 2026Article
- Association of the C-reactive protein-triglyceride-glucose (CTI) index and its central obesity-modified derivatives with incident cardiometabolic multimorbidity: results from two prospective cohorts in China and England.Cardiovascular diabetology · 2026Article
- Article
- Clonal hematopoiesis of indeterminate potential is associated with increased cardiovascular risk in chronic kidney disease.Clinical kidney journal · 2026Article
- Unraveling 'F' factor: towards a genetic-clinical framework for the musculoskeletal-heart crosstalk in metabolic aging.Cardiovascular diabetology · 2026Article
- Changes in the estimated glucose disposal rate and cardiometabolic multimorbidity in middle-aged and older adults.Cardiovascular diabetology · 2026Article
- Assessment of seven insulin resistance surrogate indexes for predicting cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study.Cardiovascular diabetology · 2026Article
- Association of C-reactive protein-triglycerides-glucose index-waist to height ratio and cardiometabolic multimorbidity in middle-aged and older adults: a nationwide cohort study.Cardiovascular diabetology · 2026Article
- Associations of eight insulin resistance-related indices and genetic risk with incident cardiometabolic multimorbidity among participants with hypertension: a large prospective cohort study.Cardiovascular diabetology · 2026Observational
- Associations of cumulative exposure and dynamic trajectories of the triglyceride-total cholesterol-body weight index with new-onset cardiometabolic multimorbidity in middle-aged and older Chinese adults: evidence from a nationwide prospective cohort study.Cardiovascular diabetology · 2026Article
- Development and validation of a cardiometabolic multimorbidity prediction model in middle-aged and older adults.Scientific reports · 2026Article
- The association of C-reactive protein-triglyceride-glucose index with cardiometabolic multimorbidity in middle-aged and older adults: evidence from two cohort studies.Cardiovascular diabetology · 2026Article
- Predictive value of an integrated insulin resistance and lipometabolic score for cardiometabolic multimorbidity in older adults: a UK cohort study.Cardiovascular diabetology · 2026Article
- Association of the triglyceride glucose-Chinese visceral adiposity index with incident cardiometabolic multimorbidity in middle-aged and older adults: a nationwide prospective cohort study.Cardiovascular diabetology · 2026Article
- Relationship between nine triglyceride-glucose-related indices and cardiometabolic multimorbidity incidence in patients with cardiovascular-kidney-metabolic syndrome stage 0-3: a nationwide prospective cohort study.Cardiovascular diabetology · 2026Observational
- Joint assessment of insulin resistance surrogate indices and basal metabolic rate for primary prevention of cardiometabolic multimorbidity: evidence from the China Health and Retirement Longitudinal Study (2011-2020).Cardiovascular diabetology · 2026Article
- Cumulative exposure and patterns of the cholesterol-HDL-C-glucose index and risk of new-onset cardiometabolic multimorbidity: 9-year longitudinal evidence from CHARLS.Frontiers in nutrition · 2026Article
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13 authors.
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Abstract
backgroundThe triglyceride-glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and estimated glucose disposal rate (eGDR) serve as surrogate markers of insulin resistance (IR) and are associated with cardiometabolic diseases (CMDs). However, the joint effects of TyG-related indices and eGDR on cardiometabolic multimorbidity (CMM) risk remains unclear. This study aims to assess both separate and combined effects of TyG-related indices and eGDR on CMM.
methodsThe data of this study derived from the China Health and Retirement Longitudinal Study (CHARLS). TyG-related indices and eGDR were dichotomized at their median levels for participant categorization. Univariate and multivariate Cox regression and restricted cubic splines (RCS) analyzed effects of TyG-related indices and eGDR on CMM, while receiver operating characteristic (ROC) curves, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) assessed their predictive performance. Meanwhile, the mutual mediating effects and interaction effects were further assessed.
resultsThis study included 5,854 participants (male: 47.5%, median age: 57.0 years). Compared to low TyG-related indices plus high eGDR, High TyG-related indices plus low eGDR had elevated CMM risks: TyG (HR 3.59, 95% CI 2.28-5.65), TyG-BMI (HR 3.40, 95% CI 2.30-5.02), TyG-WC (HR 3.85, 95% CI 2.58-5.75), and TyG-WHtR (HR 3.62, 95% CI 2.43-5.39). Furthermore, the addition of TyG-related indices combined with eGDR to the basic model significantly improved CMM risk prediction: TyG (AUC 0.713, NRI 0.363, IDI 0.008, all p < 0.05); TyG-BMI (AUC 0.729, NRI 0.479, IDI 0.011, all p < 0.05); TyG-WC (AUC 0.716, NRI 0.419, IDI 0.010, all p < 0.05); and TyG-WHtR (AUC 0.717, NRI 0.379, IDI 0.010, all p < 0.05). Moreover, the mediation analysis demonstrated that eGDR significantly mediated all TyG-related indices' associations with CMM, with only obesity-related TyG indices mediating the association between eGDR and CMM. Notably, no significant additive or multiplicative interaction was observed between any TyG-related indices and eGDR for CMM risk.
conclusionsHigh TyG-related indices and low eGDR were independently and jointly associated with higher CMM risk. Joint application of TyG-related indices and eGDR could improve early identification and prevention of CMM.
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