Lipids & metabolic liver disease
The association between triglyceride glucose-frailty index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study
Main finding · Incident CMMResult — go to the resultHazard ratio 7.86 95% CI 4.16–14.86Authors' conclusion
TyG-FI exhibits non-linear, threshold-defined associations with incident CMM and age-dependent effect modification. Machine-learning models incorporating TyG-FI show strong predictive performance. TyG-FI assessment may facilitate cost-effective risk stratification for CMM and guide targeted prevention.
Study context
- Population
- Chinese adults aged ≥ 45 years, China Health and Retirement Longitudinal Study (CHARLS)analytic cohort
- Participants
- 2,961 adults
- Exposure
- TyG-FI index
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
Methodological detailsnational, CHARLS 2011-2020 waves
- National
- CHARLS 2011-2020 waves
Main finding
Incident CMM
Hazard ratio
7.86
95% CI 4.16–14.86
Q4vs Q1
HR 7.86 (95% CI 4.16–14.86)
As reported in the abstract
- Per unit increase in TyG-FI, HR
- 1.80 (95% CI 1.57-2.05; P < 0.001)
- Graded increase in cumulative cardiometabolic multimorbidity (CMM) incidence across TyG-FI quartiles, log-rank P
- P < 0.001
Observational data: associations, not effects.
Further findings
Non-linearity (restricted cubic spline)
- J-shaped association; P for non-linearity
- P for non-linearity < 0.001
- Threshold TyG-FI
- ≈ 0.7
- Threshold cumulative TyG-FI
- ≈ 2.7
Subgroups
- Stronger associations in participants < 60 years and in normotensive individuals
Predictive performance
- Best machine-learning model RANGER, AUC
- ≈ 0.81
- TyG-FI better than Triglyceride-Glucose (TyG) index or Frailty Index (FI) alone (improved C-statistic, Integrated Discrimination Improvement (IDI), Net Reclassification Improvement (NRI))
- SHAP: cumulative and baseline TyG-FI primary predictors
Original publication
The association between triglyceride glucose-frailty index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study. Cardiovasc Diabetol. Published 3 May 2026. doi:10.
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