Cui Yuyu, Xu Zhening, Ding Lijuan, Li Yanju, Zhou Xiaoyan, Li Lingxia
Department of Physiology and Pathophysiology, Yan'an Medical College of Yan'an University, Yan'an, Shaanxi Province, China.
Department of Anesthesiology, Affiliated Hospital of Yan'an University, Yan'an, Shaanxi Province, China.
Front Cardiovasc Med. 2025 Jul 14;12:1608655. doi: 10.3389/fcvm.2025.1608655. eCollection 2025.
This study aims to systematically investigate the association between the triglyceride-glucose index multiplied by waist circumference (TyG-WC) and the risk of cardiovascular disease (CVD) and further explore how this relationship varies across different glycemic statuses, including normal glucose regulation (NGR), prediabetes (Pre-DM), and diabetes mellitus (DM).
Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 7,812 middle-aged and older adults. Kaplan-Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) regression were employed to assess the association between baseline TyG-WC and incident CVD risk. Subgroup analyses were conducted based on glucose metabolism status to evaluate potential heterogeneity in the associations.
During an average follow-up period of 8.25 years, a total of 1,638 incident CVD events were recorded, corresponding to a cumulative incidence of 20.97%. Kaplan-Meier curves showed that individuals in higher TyG-WC strata had significantly greater cumulative CVD incidence compared to those in lower strata across all glucose metabolism categories (log-rank test, < 0.05). After adjusting for potential confounders, the hazard ratios (HRs) [95% confidence intervals (CIs)] for CVD in the second, third, and fourth TyG-WC quartiles (Q2-Q4) were 1.20 (1.05-1.37), 1.30 (1.14-1.49), and 1.54 (1.34-1.77), respectively, compared to Q1. In the NGR and Pre-DM groups, TyG-WC was positively and linearly associated with CVD risk. In contrast, a significant non-linear association was observed in the DM group ( for non-linear = 0.046). Specifically, TyG-WC was positively associated with CVD risk when values were below 816.16, whereas above this threshold the increased risk plateaued and was no longer statistically significant.
TyG-WC is a practical and effective metabolic indicator for evaluating CVD risk among middle-aged and older Chinese adults. Its clinical application may facilitate early identification and precise stratification of high-risk individuals, thereby providing strong support for CVD prevention and targeted intervention strategies.
本研究旨在系统调查甘油三酯-血糖指数乘以腰围（TyG-WC）与心血管疾病（CVD）风险之间的关联，并进一步探讨这种关系在不同血糖状态下如何变化，包括正常血糖调节（NGR）、糖尿病前期（Pre-DM）和糖尿病（DM）。
数据来自中国健康与养老追踪调查（CHARLS），共纳入7812名中老年人。采用Kaplan-Meier生存分析、多变量Cox比例风险模型和限制性立方样条（RCS）回归来评估基线TyG-WC与CVD发病风险之间的关联。基于糖代谢状态进行亚组分析，以评估关联中的潜在异质性。
在平均8.25年的随访期内，共记录了1638例CVD事件，累积发病率为20.97%。Kaplan-Meier曲线显示，在所有糖代谢类别中，TyG-WC分层较高的个体与分层较低的个体相比，累积CVD发病率显著更高（对数秩检验，P<0.05）。在调整潜在混杂因素后，与第一四分位数（Q1）相比，第二、第三和第四TyG-WC四分位数（Q2-Q4）的CVD风险比（HR）[95%置信区间（CI）]分别为1.20（1.05-1.37）、1.30（1.14-1.49）和1.54（1.34-1.77）。在NGR和Pre-DM组中，TyG-WC与CVD风险呈正线性相关。相比之下，在DM组中观察到显著的非线性关联（非线性检验P=0.046）。具体而言，当TyG-WC值低于816.16时与CVD风险呈正相关，而高于此阈值时风险增加趋于平稳且不再具有统计学意义。
TyG-WC是评估中国中老年人群CVD风险的实用且有效的代谢指标。其临床应用可能有助于高危个体的早期识别和精确分层，从而为CVD预防和靶向干预策略提供有力支持。
