Evidence map›Paper›PMID 41975454›Full record

ArticleCardiovascular diabetology2026

The cholesterol, high-density lipoprotein, and glucose index and its derived indices predict diabetic kidney disease development and progression: evidence from two nationwide cohorts and a biopsy-proven clinical cohort.

Wen Cui, Shimin Jiang, Tianyu Yu, Zhenkun Yang, Jiahui Zhou, Lin Liu, Wenge Li

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Wen CuiChina-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100029, China.
Shimin JiangDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, 100029, China. jiangshimin@zryhyy.com.cn.
Tianyu YuDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, 100029, China.
Zhenkun YangChina-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100029, China.
Jiahui ZhouDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, 100029, China.
Lin LiuDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, 100029, China.
Wenge LiChina-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100029, China. liwenge@pumc.edu.cn.

Funding

National High Level Hospital Clinical Research Funding 2025-NHLHCRF-JBGS-A-WZ-05)National Key Research and Development Program of China 2025YFF0521503National Natural Science Foundation of China 82300815
6 · The paper itself

Abstract

backgroundThe Cholesterol, High-Density Lipoprotein, and Glucose (CHG) index is a recently proposed composite metric, but its utility in predicting the development and progression of diabetic kidney disease (DKD) remains insufficiently explored. This study aimed to evaluate the predictive value of the CHG index and its anthropometric-adjusted derivatives for DKD development and progression, comparing their performance with traditional surrogate markers of insulin resistance.

methodsWe analyzed 10-year longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020), including 984 diabetic patients without baseline renal injury. Incident DKD risk was evaluated using Cox proportional hazards models and Kaplan–Meier analysis, while restricted cubic splines (RCS) assessed non-linear dose–response relationships. External validation utilized the cross-sectional National Health and Nutrition Examination Survey (NHANES 1999–2018). Furthermore, disease progression (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2) was evaluated in an independent clinical cohort of 217 patients with biopsy-proven DKD. Discriminative ability was evaluated via Receiver Operating Characteristic (ROC) analyses. Subgroup and interaction analyses evaluated prognostic consistency across patient profiles.

resultsIn CHARLS, elevated CHG-BMI independently predicted incident DKD in fully adjusted models (Quartile 3 HR = 2.19, P = 0.020), showing significant integrated discrimination improvement (IDI, P = 0.030) over traditional markers. Subgroup analyses revealed higher risk estimates for CHG-BMI in non-overweight and normolipidemic individuals (P for interaction < 0.05). NHANES analysis replicated these associations, identifying significant J-shaped trajectories for CHG and CHG-BMI. In the biopsy-proven cohort, CHG and CHG-BMI were independently associated with reduced eGFR (P < 0.05), unlike traditional markers. They yielded adjusted AUCs of 0.733 and 0.730 for predicting DKD progression. E-value analysis for unmeasured confounding was 4.81 for CHG-BMI (Q3). Significant interactions emerged between CHG-BMI and Renal Pathology Society (RPS) grades, with significant associations in classes IIa and IIb.

conclusionThe CHG index and CHG-BMI independently predict DKD development and progression, outperforming traditional insulin resistance markers. Both indices aid clinical risk stratification, with CHG-BMI specifically identifying elevated risks in early pathological stages and among individuals without overt metabolic comorbidities.

Indexed as

Blood GlucoseCholesterolDiabetic NephropathiesKidneyAgedBiomarkersBiopsyChinaCross-Sectional StudiesDisease ProgressionFemaleGlomerular Filtration RateHumansIncidenceInsulin ResistanceLongitudinal StudiesBiomarkersBlood GlucoseCholesterolCholesterol, high-density lipoprotein, and glucose indexDiabetic kidney diseaseDisease progressionInsulin resistanceMulti-cohort study

Identifiers

PMID41975454
PMCPMC13196218

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.