Lipids & metabolic liver disease
Associations of cumulative exposure and dynamic trajectories of the triglyceride–total cholesterol–body weight index with new-onset cardiometabolic multimorbidity in middle-aged and older Chinese adults: evidence from a nationwide prospective cohort study
An erratum to this article was published (Cardiovasc Diabetol, 12 Aug 2026 ↗)
Authors' conclusion
Higher cumulative TCBI exposure and unfavorable TCBI trajectories are independently associated with increased CMM risk in middle-aged and older Chinese adults. The Cox-based nomogram provides a practical tool for early risk stratification, supporting targeted preventino and personalized management of CMM.
Study context
- Population
- Middle-aged and older Chinese adults, China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 5,068 participants
- Exposure
- Cumulative TCBI exposure and TCBI trajectories
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
Methodological detailsnationwide, CHARLS, Proportional hazards assumption satisfied (global P = 0.86)
- Nationwide
- CHARLS
- Proportional hazards assumption satisfied (global P = 0.86)
Main finding
As reported in the abstract
Incident CMM · follow-up
Hazard ratio (95% CI)
Per 1-SD increase in CumTCBImultivariable-adjusted
1.18(1.09–1.28)
Highest tertilevs Lowest tertilemultivariable-adjusted
1.90(1.43–2.52)
High-stablevs Low-stable
1.61(1.10–2.36)
- Developed incident cardiometabolic multimorbidity (CMM) (overall)
- 424 (8.4%)
- Nonlinear dose-response between CumTCBI and CMM risk
- P for nonlinearity < 0.001
Observational data: associations, not effects.
Further findings
Incremental predictive value of TCBI beyond its components
- Net Reclassification Improvement (NRI)
- 0.158, P < 0.001
Nomogram discrimination
- AUC, training cohort
- 0.715
- AUC, validation cohort
- 0.694
- Decision curve analysis (DCA) indicated favorable clinical net benefit
Original publication
Associations of cumulative exposure and dynamic trajectories of the triglyceride–total cholesterol–body weight index with new-onset cardiometabolic multimorbidity in middle-aged and older Chinese adults: evidence from a nationwide prospective cohort study. Cardiovasc Diabetol. Published 29 March 2026. doi:10.
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