Wang Chao, He Shiming, Xie Guobo, Zhang Shuhua, Xiong Zhiyu, Lu Hengcheng, Wang Qun, Xie Lin, Wang Wei, Zou Yang, Li Xue
Department of Cardiology, Lu'an Hospital of Anhui Medical University, Lu'an, Anhui Province, China.
Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
Cardiovasc Diabetol. 2025 Nov 12;24(1):431. doi: 10.1186/s12933-025-02972-6.
The triglyceride glucose (TyG) index and various obesity indices have been proven to be cost-effective indicators of cardiovascular disease (CVD) risk. This study aims to systematically investigate and compare the associations between longitudinal trajectories of TyG index combined with classical and novel obesity indices (TyG-BMI, TyG-WC, TyG-WHtR, TyG-WWI, TyG-ABSI, TyG-BRI, TyG-CVAI) and CVD.
The study sample comprised 3505 non-CVD participants from the CHARLS national cohort. Longitudinal data from Waves 1 and 3 of the national surveys were used to quantify cumulative exposure and trajectories of TyG and its obesity derivatives. A multi-model analytical framework (including logistic regression, spline regression, and weighted quantile sum regression models) was constructed to systematically examine the strength of associations between trajectories of TyG and its obesity derivatives and CVD, and the contribution of each component.
During 8-year median follow-up, 411 CVD cases occurred. The study demonstrated that compared to static baseline values, longitudinal assessment of cumulative exposure and trajectory of TyG and its obesity derivatives enhanced predictive capacity for CVD. Notably, combinations of TyG with classical obesity index WC and novel obesity index CVAI (TyG-WC and TyG-CVAI) exhibited superior performance for CVD risk assessment. Compared to participants with well-controlled trajectories and low exposure levels, those with poorly controlled or highest cumulative exposure to TyG index, TyG-BMI, TyG-WC, TyG-WHtR, TyG-WWI, TyG-ABSI, TyG-BRI, and TyG-CVAI had odds ratios of 1.61/1.40, 2.13/1.70, 2.00/1.78, 1.77/1.59, 1.31/1.36, 1.37/1.30, 1.76/1.56, and 2.00/1.72, respectively. Finally, weighted quantile sum regression results indicated that cumulative exposure to obesity and triglycerides contributed most to CVD risk among all metabolic indices, suggesting that simultaneous regulation of triglycerides and obesity may be critical for reducing CVD risk.
In this cohort study, the longitudinal trajectories of TyG and its obesity derivatives were closely associated with CVD. Comparatively, the combinations of TyG with classical obesity index WC and novel obesity index CVAI (TyG-WC and TyG-CVAI) exhibited superior performance for CVD risk assessment, with this risk primarily driven by obesity and triglycerides.
甘油三酯葡萄糖（TyG）指数和各种肥胖指数已被证明是心血管疾病（CVD）风险的经济有效指标。本研究旨在系统地调查和比较TyG指数与经典和新型肥胖指数（TyG-BMI、TyG-WC、TyG-WHtR、TyG-WWI、TyG-ABSI、TyG-BRI、TyG-CVAI）的纵向轨迹与CVD之间的关联。
研究样本包括来自中国健康与养老追踪调查（CHARLS）全国队列的3505名无CVD参与者。利用全国调查第1轮和第3轮的纵向数据来量化TyG及其肥胖衍生指标的累积暴露和轨迹。构建了一个多模型分析框架（包括逻辑回归、样条回归和加权分位数和回归模型），以系统地检验TyG及其肥胖衍生指标的轨迹与CVD之间的关联强度以及各成分的贡献。
在8年的中位随访期内，发生了411例CVD病例。研究表明，与静态基线值相比，对TyG及其肥胖衍生指标的累积暴露和轨迹进行纵向评估可增强对CVD的预测能力。值得注意的是，TyG与经典肥胖指数WC和新型肥胖指数CVAI（TyG-WC和TyG-CVAI）的组合在CVD风险评估中表现出卓越性能。与轨迹控制良好且暴露水平低的参与者相比，TyG指数、TyG-BMI、TyG-WC、TyG-WHtR、TyG-WWI、TyG-ABSI、TyG-BRI和TyG-CVAI轨迹控制不佳或累积暴露最高的参与者的比值比分别为1.61/1.40、2.13/1.70、2.00/1.78、1.77/1.59、1.31/1.36、1.37/1.30、1.76/1.56和2.00/1.72。最后，加权分位数和回归结果表明，在所有代谢指标中，肥胖和甘油三酯的累积暴露对CVD风险的贡献最大，这表明同时调节甘油三酯和肥胖可能对降低CVD风险至关重要。
在这项队列研究中，TyG及其肥胖衍生指标的纵向轨迹与CVD密切相关。相比之下，TyG与经典肥胖指数WC和新型肥胖指数CVAI（TyG-WC和TyG-CVAI）的组合在CVD风险评估中表现出卓越性能，这种风险主要由肥胖和甘油三酯驱动。
