Predictive value of the combined cholesterol, high-density lipoprotein, glucose and frailty indices for cardiometabolic multimorbidity incidence: evidence from a national prospective cohort study
Authors' conclusion
The combined CHG-frailty index was significantly associated with incident cardiometabolic multimorbidity and its individual components, demonstrating predictive performance comparable to established combined indices. As an accessible tool integrating routine metabolic and physiologic reserve measures, CHG-FI offers a practical alternative approach for risk stratification.
Study context
- Population
- Chinese adults aged ≥ 45 years in China Health and Retirement Longitudinal Study (CHARLS) with baseline lipid and fasting glucose measurements
- Participants
- 6,812 adults
- Exposure
- Per 1-unit increase in combined CHG-frailty index
- Outcome
- Incident heart disease, stroke, diabetes and cardiometabolic multimorbidity (CMM; ≥ 2 conditions)
- Follow-up
- Median 9.0 years
Methodological detailsnational, CHARLS 2011-2020 waves
- National
- CHARLS 2011-2020 waves
Main finding
As reported in the abstract
Heart disease (1,304 events), HR per 1-unit CHG-frailty index (CHG-FI)
HR 1.34, 95% CI 1.23-1.45
Stroke (554 events), HR per 1-unit CHG-FI
HR 1.85, 95% CI 1.65-2.06
Diabetes (932 cases), HR per 1-unit CHG-FI
HR 1.29, 95% CI 1.17-1.42
Cardiometabolic multimorbidity (CMM) (467 cases), HR per 1-unit CHG-FI
HR 1.79, 95% CI 1.58-2.04
Observational data: associations, not effects.
Further findings
Multiplicative interaction between CHG and FI for CMM
- Multiplicative interaction ("risk saturation" or ceiling effect)
- 0.54 (95% CI 0.35-0.83)
Predictive performance of CHG-FI for CMM vs individual components
- AUC
- 0.652 (95% CI 0.627-0.678)
- Net reclassification improvement (NRI)
- 0.329 (95% CI 0.236-0.423)
- IDI
- 0.011 (95% CI 0.008-0.015)
- CHG-FI and TyG-FI broadly comparable performance across outcomes
Original publication
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