Baseline, repeated-measure burden, and two-time-point patterns of the triglyceride-glucose index-visceral lipid ratio (triglyceride-glucose-visceral lipid ratio (TyG-VLR)) and incident cardiovascular disease in cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3: a longitudinal China Health and Retirement Longitudinal Study (CHARLS) analysis
Authors' conclusion
In middle-aged and older adults with adapted CKM syndrome stages 0-3, higher baseline TyG-VLR, repeated-measure TyG-VLR burden, and higher two-time-point TyG-VLR patterns were associated with incident CVD, particularly stroke.
Study context
- Population
- Middle-aged and older adults with adapted CKM syndrome stages 0–3 (no overt clinical cardiovascular disease (CVD)), CHARLS, follow-up through 2020 wave1,688 incident CVD events
- Participants
- 7,132 participants
- Exposure
- Higher vs lower TyG-VLR
- Outcome
- Incident CVD
- Follow-up
- Median 9.00 years (IQR, 7.00-9.00)
Methodological detailslongitudinal, landmark analysis, K-means clustering, prespecified sensitivity analyses
- Longitudinal
- Landmark analysis
- K-means clustering
- Prespecified sensitivity analyses
Main finding
As reported in the abstract
Hazard ratio (95% CI)
Each 1-SD increase in baseline TyG-VLR
1.15(1.10–1.21)
Repeated-measure TyG-VLR burdenrepeated-measure cohort, n=4,111, 777 events
1.21(1.12–1.30)
Highest two-time-point patternvs Lowest two-time-point patternrepeated-measure cohort
1.51(1.22–1.85)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Heart disease (per 1-SD baseline TyG-VLR) | 1.11 (1.05–1.18) | |
| Stroke (per 1-SD baseline TyG-VLR) | 1.21 (1.12–1.31) | |
| 0.512Hazard ratio (log scale) |
Marker comparisons, discrimination and sensitivity analyses
- Graded CVD risk patterns on restricted cubic spline and Kaplan-Meier analyses
- TyG-VLR performed broadly similarly to visceral lipid ratio (VLR), CVAI and TyG-CVAI
- Incremental discrimination beyond traditional factors and adapted CKM stage was modest
- Associations consistent in inverse probability-weighted, multiple-imputation, alternative-formulation and competing-risk analyses
Original publication
Baseline, repeated-measure burden, and two-time-point patterns of the triglyceride-glucose index-visceral lipid ratio (TyG-VLR) and incident cardiovascular disease in cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3: a longitudinal China Health and Retirement Longitudinal Study (CHARLS) analysis. Cardiovasc Diabetol. Published 25 July 2026. doi:10.
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