Assessing the impact of insulin resistance trajectories on cardiovascular disease risk using longitudinal targeted maximum likelihood estimation
Main finding · CVD risk by TyG-BMI trajectory (LTMLE)Result — go to the resultOdds ratio 1.694 95% CI 1.361–2.108Authors' conclusion
High stable and increasing TyG-BMI and TyG index trajectories were associated with the risk of CVD. TyG-BMI consistently exhibited higher odds ratios (ORs) of CVD risk when comparing with TyG index. Early identification of IR trajectories could provide insights for preventing CVD later in life.
Study context
- Population
- Chinese nationwide cohort (China Health and Retirement Longitudinal Study (CHARLS)); 54.3% female; mean baseline age 58.28 years
- Participants
- 3,966 participants
- Exposure
- Triglyceride-glucose (TyG) index and TyG-BMI trajectories: high stable, increasing, decreasing vs low stable
- Outcome
- Incident CVD
- Follow-up
- 7-year follow-up
Methodological detailsnationwide cohort (CHARLS), longitudinal targeted maximum likelihood estimation (LTMLE), adjusted for time-invariant and time-varying confounders
- Nationwide cohort (CHARLS)
- Longitudinal targeted maximum likelihood estimation (LTMLE)
- Adjusted for time-invariant and time-varying confounders
Main finding
CVD risk by TyG-BMI trajectory (LTMLE)
Odds ratio
1.694
95% CI 1.361–2.108
High stablevs Low stable
OR 1.694 (95% CI 1.361–2.108)
As reported in the abstract
- Similar trends across other models: OR in Model 2
- 1.708 (95% CI: 1.367-2.134)
- OR in Model 3
- 1.389 (1.083-1.782)
- OR in Model 4
- 1.675 (1.185-2.366)
- OR in Model 5
- 1.375 (95% CI:1.07 - 1.768)
Observational data: associations, not effects.
Further findings
Incident cardiovascular disease (CVD) (overall) · 7-year follow-up
- Participants who developed CVD
- 499 (12.6%)
CVD (TyG index trajectories)
- Results consistent with TyG-BMI, with slightly lower magnitude of odds ratios (ORs)
Original publication
Assessing the impact of insulin resistance trajectories on cardiovascular disease risk using longitudinal targeted maximum likelihood estimation. Cardiovasc Diabetol. Published 10 March 2025. doi:10.
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