ArticleCardiovascular diabetology2025
The association between triglyceride glucose-waist height ratio index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Long-term cumulative exposure and change patterns of CTI-FI predict the risk of cardiometabolic multimorbidity in middle-aged and older Chinese adults.Journal of diabetes and metabolic disorders · 2026Article
- Article
- Predictive value of the combined cholesterol, high-density lipoprotein, glucose and frailty indices for cardiometabolic multimorbidity incidence: evidence from a national prospective cohort study.Cardiovascular diabetology · 2026Article
- The association between triglyceride glucose-frailty index and cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study.Cardiovascular diabetology · 2026Article
- Assessment of seven insulin resistance surrogate indexes for predicting cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study.Cardiovascular diabetology · 2026Article
- Associations of eight insulin resistance-related indices and genetic risk with incident cardiometabolic multimorbidity among participants with hypertension: a large prospective cohort study.Cardiovascular diabetology · 2026Observational
- The association of C-reactive protein-triglyceride-glucose index with cardiometabolic multimorbidity in middle-aged and older adults: evidence from two cohort studies.Cardiovascular diabetology · 2026Article
- Association of the triglyceride glucose-Chinese visceral adiposity index with incident cardiometabolic multimorbidity in middle-aged and older adults: a nationwide prospective cohort study.Cardiovascular diabetology · 2026Article
- Relationship between nine triglyceride-glucose-related indices and cardiometabolic multimorbidity incidence in patients with cardiovascular-kidney-metabolic syndrome stage 0-3: a nationwide prospective cohort study.Cardiovascular diabetology · 2026Article
- The associations of the triglyceride-glucose index and estimated glucose disposal rate with incident cardiometabolic multimorbidity vary across obesity phenotypes: a longitudinal cohort study.Frontiers in nutrition · 2026Article
- Beyond glucose: wearable and implantable biosensors for continuous monitoring of metabolic, hormonal, and inflammatory biomarkers in personalized cardiometabolic care.Frontiers in bioengineering and biotechnology · 2026Review
- The association between HbA1c/HDL-C ratio and cardiometabolic multimorbidity among middle-aged and older adults: data from two national prospective cohorts in the United Kingdom and United States.Frontiers in nutrition · 2026Article
- Comparison of the TyG index, TyG-traditional obesity indices, and TyG-novel obesity indices: does increased complexity help in predicting cardiometabolic multimorbidity?Lipids in health and disease · 2025Article
- Association between triglyceride-glucose index combined with a body shape index and atherosclerotic cardiovascular disease risk varies by glycemic status: insights from the UK Biobank.Cardiovascular diabetology · 2025Article
- Triglyceride-glucose index, a silent predictor for osteosarcopenic adiposity occurrence and risk of cardiovascular and all-cause mortality.Diabetology & metabolic syndrome · 2025Article
- Effects of moderate-to-vigorous physical activity on the associations between an insulin resistance surrogate and incident cardiovascular disease and all-cause mortality: a UK Biobank cohort study.Frontiers in endocrinology · 2025Article
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Funding
Abstract
backgroundCardiometabolic multimorbidity (CMM) imposes a progressively severe health burden worldwide. Triglyceride-glucose (TyG) index and waist-to-height ratio (WHtR), as indicators of insulin resistance and central adiposity, respectively, have been shown to be strongly associated with CMM. However, there is currently a lack of research combining the two for CMM risk assessment. This study aims to investigate the relationship between TyG-WHtR index and CMM.
methodsThis prospective cohort study analyzed data from Chinese adults aged ≥ 45 years participating in the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). We employed the Kaplan-Meier curves, multivariable Cox regression analysis, and restricted cubic spline (RCS) to examine the relationship between the TyG-WHtR index and the risk of CMM. Time-dependent receiver operating characteristic (ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analyses were utilized to evaluate predictive performance. Additionally, subgroup analyses and sensitivity tests were conducted to assess the robustness of the findings.
resultsDuring a median follow-up of 9 years, 413 (9.4%) of the 4393 participants developed CMM. Multivariable Cox regression analysis revealed progressively higher risks of CMM across increasing TyG-WHtR quartiles. Compared to participants in the lowest quartile (Q1) of the TyG-WHtR index, the hazard ratios (HRs) and 95% confidence intervals (CIs) for those in quartiles Q2, Q3, and Q4 were 1.75 (1.18-2.6), 2.33 (1.58-3.43), and 3.13 (2.08-4.7), respectively. Consistently, elevated cumulative TyG-WHtR independently increased CMM risk. The RCS analysis indicated a positive linear relationship between the TyG-WHtR index and the incidence of CMM. Moreover, both baseline and cumulative TyG-WHtR significantly improved reclassification metrics (NRI/IDI) and discriminative ability (AUC). Sensitivity analyses corroborated these primary findings.
conclusionThis study suggests that TyG-WHtR independently predicts CMM risk. The linear dose-response relationship highlight the potential utility of TyG-WHtR in early risk assessment and prevention strategies for CMM.
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