Lipids & metabolic liver disease

Comprehensive evaluation of the triglyceride glucose index (triglyceride-glucose (TyG)) and body roundness index (BRI) on cardiovascular disease risk prediction: a 9-year prospective cohort study in Chinese middle-aged and older adults

Cardiovasc DiabetolPublished Prospective cohort study

Authors' conclusion

In conclusion, our study highlights the critical role of BRI as a mediator in the relationship between TyG and CVD risk. The findings indicate that both baseline and follow-up BRI significantly contribute to the pathway linking TyG to CVD, suggesting that individuals with higher BRI are at an increased risk. The antagonistic interaction underscores the complexity of metabolic risk factors in CVD development and emphasizes the need for a multifaceted approach in risk assessment and management. Future research should focus on elucidating the biological mechanisms underlying this interaction and exploring potential interventions that target body composition and metabolic health to mitigate CVD risk in high-risk populations.

Study context

Population
Chinese middle-aged and older adults without pre-existing cardiovascular disease (CVD), China Health and Retirement Longitudinal Study (CHARLS) 2011–2020
Participants
7,853 participants
Exposure
TyG and BRI in relation to CVD risk
Outcome
Incident CVD
Follow-up
Median 9.0 years
Methodological detailsChina Health and Retirement Longitudinal Study (CHARLS) 2011–2020
  • China Health and Retirement Longitudinal Study (CHARLS) 2011–2020

Main finding

As reported in the abstract

Developed CVD
1,922 (24.48%)
Baseline BRI mediated share of TyG–CVD association
40.14%
Indirect effect HR via baseline BRI
1.053 (95% CI 1.035-1.073)
Follow-up BRI mediated share of TyG–CVD association
51.46%
Indirect effect HR via follow-up BRI
1.046 (95% CI 1.028-1.068)
Increase in follow-up TyG per SD increase in baseline BRI (SD)
0.12

Observational data: associations, not effects.

Further findings

Weighted quantile sum (WQS) analysis: most substantial contributor

Waist circumference weight
0.523

Composite indexes with hs-CRP

CVD risk with TyG + BRI, HR
1.773 (95% CI 1.499-2.097)
Discriminatory ability for CVD, AUC
< 0.65
Joint elevation of TyG-BRI and TyG + BRI with hs-CRP further stratified CVD risk; elevation of all markers had highest risk

Original publication

Comprehensive evaluation of the triglyceride glucose index (TyG) and body roundness index (BRI) on cardiovascular disease risk prediction: a 9-year prospective cohort study in Chinese middle-aged and older adults. Cardiovasc Diabetol. Published 24 April 2026. doi:10.1186/s12933-026-03092-5

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