The cholesterol, high-density lipoprotein, and glucose index and its derived indices predict diabetic kidney disease development and progression: evidence from two nationwide cohorts and a biopsy-proven clinical cohort
Performance · Incident DKD (CHARLS)Result — go to the resultHazard ratio 2.19Authors' conclusion
The CHG index and CHG-BMI independently predict DKD development and progression, outperforming traditional insulin resistance markers.
Study context
- Population
- Diabetic patients without baseline renal injury (China Health and Retirement Longitudinal Study (CHARLS) 2011–2020); validation in NHANES 1999–2018; patients with biopsy-proven diabetic kidney disease (DKD)CHARLS
- Participants
- 984 patients
- Comparison
- CHG index and derived indices (e.g. CHG-BMI) vs traditional insulin resistance surrogate markers for predicting DKD
- Outcome
- Incident DKD
Methodological details10-year longitudinal cohort (CHARLS), external validation in cross-sectional NHANES, independent biopsy-proven clinical cohort
- 10-year longitudinal cohort (CHARLS)
- External validation in cross-sectional NHANES
- Independent biopsy-proven clinical cohort
Performance
Incident DKD (CHARLS)
Hazard ratio
2.19
P = 0.020
As reported in the abstract
- Significant integrated discrimination improvement of CHG-BMI over traditional markers
- Integrated discrimination improvement (IDI), P = 0.030
Further findings
Incident DKD by subgroup (CHARLS)
- Higher risk estimates for CHG-BMI in non-overweight and normolipidemic individuals
- P for interaction < 0.05
NHANES validation
- Associations replicated; significant J-shaped trajectories for CHG and CHG-BMI
Reduced eGFR in biopsy-proven DKD cohort
- CHG and CHG-BMI independently associated with reduced eGFR, unlike traditional markers
- P < 0.05
- Adjusted AUC for predicting DKD progression, CHG
- 0.733
- Adjusted AUC for predicting DKD progression, CHG-BMI
- 0.730
- Significant interactions between CHG-BMI and Renal Pathology Society (RPS) grades, with significant associations in classes IIa and IIb
E-value for unmeasured confounding, CHG-BMI (Q3)
- E-value
- 4.81
Original publication
The cholesterol, high-density lipoprotein, and glucose index and its derived indices predict diabetic kidney disease development and progression: evidence from two nationwide cohorts and a biopsy-proven clinical cohort. Cardiovasc Diabetol. Published 13 April 2026. doi:10.
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