Association between triglyceride glucose-body mass index and the trajectory of cardio-renal-metabolic multimorbidity: insights from multi-state modelling
Authors' conclusion
TyG-BMI remarkably influences the onset and progression of CRM multimorbidity. Incorporating it into CRM multimorbidity prevention and management could have important public health implications.
Study context
- Population
- UK Biobank participants without baseline cardio-renal-metabolic (CRM) disease; mean age 56.05 (SD 8.08), 55.93% female
- Participants
- 349,974 participants
- Exposure
- Per SD increase in triglyceride glucose-body mass index (TyG-BMI)
- Outcome
- CRM multimorbidity trajectory: new-onset ischemic heart disease, T2D or CKD (first, double, triple CRM disease)
- Follow-up
- Median ≈14 years
Methodological detailsUK Biobank, multi-state model, multivariable Cox regression
- UK Biobank
- Multi-state model
- Multivariable Cox regression
Main finding
As reported in the abstract
CRM multimorbidity transitions (multi-state model), per SD TyG-BMI
Increased risk of new CRM disease
32%
Increased risk of progression to double CRM disease
24%
Increased risk of further progression for those with double CRM diseases
23%
Observational data: associations, not effects.
Further findings
CRM disease incidence · median follow-up ≈14 years
- Developed ≥1 CRM disease
- 56,659 (16.19%)
- Progressed to double CRM disease
- 8451 (14.92%)
- Further developed triple CRM disease
- 789 (9.34%)
Crude model, per SD increase in TyG-BMI
- Higher risk of first CRM disease
- 47%
- Higher risk of double CRM disease
- 72%
- Higher risk of triple CRM disease
- 95%
- C-statistics (first, double, triple)
- 0.625, 0.694, 0.764
- Crude model
Disease-specific and subgroup analyses
- TyG-BMI significantly associated with onset of all individual first CRM diseases (except stroke) and with transition to double CRM disease
- Significant interactions, but association remained significant across subgroups
- Sensitivity analyses confirmed findings
Original publication
Association between triglyceride glucose-body mass index and the trajectory of cardio-renal-metabolic multimorbidity: insights from multi-state modelling. Cardiovasc Diabetol. Published 21 March 2025. doi:10.
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