Effects of adiposity, insulin resistance, and inflammation on cardiometabolic multimorbidity: insights from interaction analyses and metabolic phenotyping in the China health and retirement longitudinal study 2011–2018
Authors' conclusion
Optimal cut-offs offer practical screening tools. Dual elevation markedly increases CMM risk and insulin resistance mediates adiposity effects. Clustering identified insulin-resistant and obese-insulin-resistant phenotypes, supporting phenotype-based prevention.
Study context
- Population
- Participants of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018
- Participants
- 6,510 participants
- Outcome
- Incident cardiometabolic multimorbidity (≥2 of DM, heart disease and stroke)
- Follow-up
- 7 years
Methodological detailslongitudinal, mediation analysis, K-means clustering
- Longitudinal
- Mediation analysis
- K-means clustering
Main finding
As reported in the abstract
Incident CMM
- Developed cardiometabolic multimorbidity (CMM)
- 212 (3.26%)
- Optimal cut-off: age
- 60 years
- Optimal cut-off: Body mass index (BMI)
- 25.6 kg/m²
- Optimal cut-off: Waist circumference (WC)
- 90.6 cm
- Optimal cut-off: Triglyceride-glucose (TyG) index
- 8.7
- Optimal cut-off: LDL-C
- 154.3 mg/dL
- Optimal cut-off: High-sensitivity C-reactive protein (hs-CRP)
- 0.86 mg/L
- TyG index mediated share of BMI effect on CMM
- 14.6%
- TyG index mediated share of WC effect on CMM
- 10.0%
Observational data: associations, not effects.
Original publication
Effects of adiposity, insulin resistance, and inflammation on cardiometabolic multimorbidity: insights from interaction analyses and metabolic phenotyping in the China health and retirement longitudinal study 2011–2018. Cardiovasc Diabetol. Published 3 June 2026. doi:10.
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