Joint effects of triglyceride glucose index and its obesity-related derivatives with estimated glucose disposal rate on cardiometabolic multimorbidity in middle-aged and older Chinese adults: a nationwide cohort study
Authors' conclusion
High TyG-related indices and low eGDR were independently and jointly associated with higher CMM risk. Joint application of TyG-related indices and eGDR could improve early identification and prevention of CMM.
Study context
- Population
- Middle-aged and older Chinese adults, China Health and Retirement Longitudinal Study (CHARLS); male 47.5%, median age 57.0 years
- Participants
- 5,854 participants
- Exposure
- High triglyceride-glucose (TyG)-related indices plus low estimated glucose disposal rate (eGDR) vs low TyG-related indices plus high eGDR
- Outcome
- Cardiometabolic multimorbidity (CMM)
Methodological detailsnationwide, CHARLS
- Nationwide
- CHARLS
Main finding
As reported in the abstract
CMM risk
High TyG-related indices plus low eGDR vs Low TyG-related indices plus high eGDRHazard ratio (95% CI)
TyG
3.59(2.28–5.65)
TyG-BMI
3.40(2.30–5.02)
TyG-WC
3.85(2.58–5.75)
TyG-WHtR
3.62(2.43–5.39)
Observational data: associations, not effects.
Further findings
Cardiometabolic multimorbidity (CMM) risk prediction: TyG-related indices plus eGDR added to basic model
- TyG: AUC, net reclassification improvement (NRI), integrated discrimination improvement (IDI) (all p < 0.05)
- AUC 0.713, NRI 0.363, IDI 0.008
- TyG-body mass index (TyG-BMI): AUC, NRI, IDI (all p < 0.05)
- AUC 0.729, NRI 0.479, IDI 0.011
- TyG-waist circumference (TyG-WC): AUC, NRI, IDI (all p < 0.05)
- AUC 0.716, NRI 0.419, IDI 0.010
- TyG-waist-to-height ratio (TyG-WHtR): AUC, NRI, IDI (all p < 0.05)
- AUC 0.717, NRI 0.379, IDI 0.010
Mediation
- eGDR significantly mediated all TyG-related indices' associations with CMM; only obesity-related TyG indices mediated the eGDR–CMM association
Interaction
- No significant additive or multiplicative interaction between any TyG-related index and eGDR for CMM risk
Original publication
Joint effects of triglyceride glucose index and its obesity-related derivatives with estimated glucose disposal rate on cardiometabolic multimorbidity in middle-aged and older Chinese adults: a nationwide cohort study. Cardiovasc Diabetol. Published 2 October 2025. doi:10.
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