Association of various insulin resistance surrogate indices with aging acceleration and future risk of cardiovascular disease in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: insights from China Health and Retirement Longitudinal Study (CHARLS) 2011–2020 data
Authors' conclusion
Multiple IR surrogate indices independently predict cardiovascular disease in CKM stages 0-3, with biological aging acceleration mediating this association. Integrating these measures into risk stratification could enable early identification and targeted intervention for high-risk individuals.
Study context
- Population
- Participants with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3, China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 6,318 participants
- Exposure
- 12 insulin resistance (IR) surrogate indices in relation to incident cardiovascular disease (CVD)
- Outcome
- New-onset CVD
Methodological detailsmultivariable-adjusted logistic regression, restricted cubic splines, quantile-based models, mediation analyses
- Multivariable-adjusted logistic regression
- Restricted cubic splines
- Quantile-based models
- Mediation analyses
Main finding
As reported in the abstract
- Developed new-onset CVD
- 1231 (19.5%)
- All IR surrogates significantly associated with CVD risk: TyG-derived indices, METS-IR, CTI and TG/HDL-C positive; eGDR inverse
- all P-trend < 0.05
Observational data: associations, not effects.
Further findings
Effect modification
- Significant modification by biological ageing acceleration, gender and CKM stage
Mediation by biological aging acceleration
- Proportion of TyG-ABSI–CVD association mediated
- 14.9-16.4%
- Proportion of other IR–CVD relationships mediated
- 1.3-4.2%
Original publication
Association of various insulin resistance surrogate indices with aging acceleration and future risk of cardiovascular disease in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: insights from CHARLS 2011–2020 data. Cardiovasc Diabetol. Published 4 February 2026. doi:10.
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