Longitudinal associations of cumulative and repeated-measure patterns of insulin resistance surrogate indices with biological age acceleration and incident cardiovascular disease across cardiovascular-kidney-metabolic syndrome stages 0–3: evidence from CHARLS 2011–2020
Authors' conclusion
Sustained IR burden and unfavorable longitudinal IR patterns are linked to higher CVD risk in CKM stages 0-3, partly through accelerated biological aging. Integrating longitudinal IR profiling with aging metrics may sharpen early risk stratification and support scalable prevention targeting upstream metabolic drivers.
Study context
- Population
- Participants with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3, CHARLS 2011–2020
- Participants
- 3,948 participants
- Exposure
- Cumulative and longitudinal pattern groups of 12 insulin resistance (IR) surrogate indices and incident cardiovascular disease (CVD)
- Outcome
- Incident CVD
Methodological detailslongitudinal, Fine-Gray competing risk models, K-means-derived pattern groups, mediation analyses
- Longitudinal
- Fine-Gray competing risk models
- K-means-derived pattern groups
- Mediation analyses
Main finding
As reported in the abstract
Developed incident CVD
756
19.1%
Observational data: associations, not effects.
Further findings
Predictive performance for CVD risk
- Cumulative eGDR AUC (all DeLong P < 0.05 vs other indices)
- 0.613
- Cumulative eGDR top contributor by both WQS and Qgcomp analyses
Mediation by biological age acceleration
- KDM-BioAgeAccel partially mediated several IR-CVD associations, up to
- 45.8%
- Light-BioAgeAccel partially mediated several IR-CVD associations, up to
- 25.9%
Original publication
Longitudinal associations of cumulative and repeated-measure patterns of insulin resistance surrogate indices with biological age acceleration and incident cardiovascular disease across cardiovascular-kidney-metabolic syndrome stages 0–3: evidence from CHARLS 2011–2020. Cardiovasc Diabetol. Published 16 May 2026. doi:10.
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