Lipids & metabolic liver disease
The prognostic significance of cholesterol, high-density lipoprotein and glucose (CHG) index in evaluating all-cause mortality risk in metabolic dysfunction-associated steatotic liver disease (MASLD) individuals: evidence from two cohort studies
Main finding · All-cause mortalityResult — go to the resultHazard ratio 1.49 95% CI 1.21–1.84Authors' conclusion
Elevated CHG index is significantly associated with an increased risk of mortality in the Chinese MASLD population, demonstrating a nonlinear relationship. Furthermore, indicators related to inflammation and insulin resistance (IR) significantly mediate these associations.
Study context
- Population
- Participants with MASLD, China Health and Retirement Longitudinal Study (CHARLS) 2011–2020; external validation in National Health and Nutrition Examination Survey (NHANES) (1999–2018)CHARLS
- Participants
- 6,936 participants
- Exposure
- Highest vs lowest CHG index tertile
- Outcome
- All-cause mortality
- Follow-up
- Median 7.44 years
Methodological detailstwo cohorts, external validation (NHANES), machine learning models, mediation analysis
- Two cohorts
- External validation (NHANES)
- Machine learning models
- Mediation analysis
Main finding
As reported in the abstract
Hazard ratio
1.49
95% CI 1.21–1.84
P = 0.0002
Highest tertilevs Lowest tertile
HR 1.49 (95% CI 1.21–1.84); P = 0.0002
- Mortality events
- 615
Observational data: associations, not effects.
Further findings
Survival by CHG index (Kaplan-Meier)
- Higher CHG index associated with reduced survival
- P < 0.0001
- Nonlinear relationship between CHG index and mortality
Mediation of CHG index effect on mortality
- Mediated by C-reactive protein (CRP)
- 13.36%
- Mediated by TyG-WWI
- 45.33%
- All P < 0.05
Prediction models (8 machine learning (ML) models)
- Logistic Regression model showed superior discrimination and significant clinical net benefit on decision curve analysis
External validation (NHANES)
- Significant positive association between CHG index and mortality
Original publication
The prognostic significance of cholesterol, high-density lipoprotein and glucose (CHG) index in evaluating all-cause mortality risk in metabolic dysfunction-associated steatotic liver disease (MASLD) individuals: evidence from two cohort studies. Cardiovasc Diabetol. Published 6 April 2026. doi:10.
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