Joint longitudinal trajectories of the triglyceride-glucose index combined with body mass index (BMI) and waist-to-height ratio and incident cardiovascular disease: a prospective cohort study from the English longitudinal study of ageing
Authors' conclusion
Both approaches yield robust and comparable dose-response gradients, supporting further validation of serial TyG-related composite index monitoring for cardiovascular risk stratification in aging populations.
Study context
- Population
- Cardiovascular disease (CVD)-free adults aged ≥50 years, English Longitudinal Study of Ageing; Triglyceride-glucose (TyG) with BMI and waist-to-height ratio (WHtR) measured across three waves over ≈8 years
- Participants
- 1,808 adults
- Exposure
- Joint TyG + BMI and TyG + WHtR trajectory groups vs normal weight-low TyG reference
- Outcome
- Incident composite CVD
Methodological detailsgroup-based multi-trajectory modeling, Cox proportional hazards models with four sequential adjustment models
- Group-based multi-trajectory modeling
- Cox proportional hazards models with four sequential adjustment models
Main finding
As reported in the abstract
Composite CVD (fully adjusted BMI + TyG models)
Each group vs normal weight-low TyGHazard ratio (95% CI)
Overweight-moderate TyG
2.31(1.40–3.83)
Obese-high TyG
2.72(1.63–4.52)
Severely obese-high TyG
5.06(3.01–8.51)
- Incident CVD during follow-up
- 263 participants (14.5%)
Observational data: associations, not effects.
Further findings
Composite CVD, WHtR + TyG approach (ascending risk groups vs reference)
- Consistent dose-response pattern; Hazard ratios (HRs) for ascending risk groups
- 2.22, 2.75, and 5.12
- Fully adjusted
Stroke
- Only the highest-risk groups reached statistical significance (BMI + TyG and WHtR + TyG, respectively), HR
- 6.74 and 5.00
Discrimination: BMI + TyG vs WHtR + TyG approaches
- No significant difference between the two approaches; C-statistic difference
- 0.003, P = 0.723
Sensitivity analyses
- All nine sensitivity analyses consistently corroborated the primary findings
Original publication
Joint longitudinal trajectories of the triglyceride-glucose index combined with BMI and waist-to-height ratio and incident cardiovascular disease: a prospective cohort study from the English longitudinal study of ageing. Cardiovasc Diabetol. Published 5 July 2026. doi:10.
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