Lipids & metabolic liver disease
Predictive value of an integrated insulin resistance and lipometabolic score for cardiometabolic multimorbidity in older adults: a UK cohort study
Authors' conclusion
The integrated index combining insulin resistance and lipid dysregulation was associated with incident CMM and provided modest improvements in risk discrimination and reclassification beyond traditional risk factors.
Study context
- Population
- Older adults in the English Longitudinal Study of Ageing552 cardiometabolic multimorbidity (CMM) cases
- Participants
- 4,232 adults
- Exposure
- Per-SD increase in triglyceride-glucose (TyG), estimated glucose disposal rate (eGDR), atherogenic index of plasma (AIP), remnant cholesterol (RC) and a composite metabolic index
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
- Follow-up
- 6.8-year follow-up
Methodological detailsEnglish Longitudinal Study of Ageing, composite index by principal component analysis, multivariable Cox proportional hazards models
- English Longitudinal Study of Ageing
- Composite index by principal component analysis
- Multivariable Cox proportional hazards models
Main finding
As reported in the abstract
Incident CMM per SD increase (multivariable-adjusted)
- TyG, HR per SD
- 1.308 (95% CI 1.202-1.422)
- AIP, HR per SD
- 1.222 (95% CI 1.117-1.338)
- RC, HR per SD
- 1.076 (95% CI 1.025-1.129)
- eGDR, HR per SD
- 0.650 (95% CI 0.565-0.747)
- Composite metabolic index, HR per SD
- 0.626 (95% CI 0.554-0.707)
Observational data: associations, not effects.
Further findings
Population attributable fraction
- eGDR Population attributable fraction (PAF)
- 56.3% (95% CI 47.3-63.4)
- CompositeIndex PAF
- 38.3% (95% CI 29.8-47.8)
Predictive performance of CompositeIndex
- AUC (95% CI 0.737-0.778); highest discrimination
- 0.754
- Net reclassification improvement (NRI) (0.027-0.106)
- 0.066
Dose-response
- Near-linear relationships for all indices
Subgroups by age and sex
- Associations more pronounced in participants <65 years and consistent across sex
Original publication
Predictive value of an integrated insulin resistance and lipometabolic score for cardiometabolic multimorbidity in older adults: a UK cohort study. Cardiovasc Diabetol. Published 4 February 2026. doi:10.
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