ArticlePloS one2026
Cumulative average triglyceride glucose-waist height index and incident cardiovascular disease in middle-aged and older adults: A nationwide cohort study from the china health and retirement longitudinal study.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundInsulin resistance (IR) is a significant risk factor for cardiovascular disease (CVD), yet practical biomarkers for long-term IR assessment are limited. The triglyceride glucose-waist-to-height ratio (TyG-WHtR) index, integrating lipid/glucose metabolism and central obesity, offers a novel composite marker. We investigated the association between cumulative average TyG-WHtR and incident CVD in middle-aged and older adults.
methodsThis prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). Participants aged ≥45 years without baseline CVD were included (n = 5,328). Cumulative average TyG-WHtR was calculated from Wave 1 (2011) and Wave 3 (2015) using the formula: [TyG × WHtR], where TyG = ln[(TG mg/dL × FBG mg/dL)/2] and WHtR = waist circumference (cm)/height (cm). Incident CVD was defined as new self-reported physician-diagnosed heart disease/stroke or active treatment during follow-up. Multivariable logistic regression and restricted cubic spline models assessed associations, adjusting for demographics, lifestyle, cardiometabolic risk factors, and comorbidities.
resultsOver 4 years, 568 (10.7%) participants developed CVD. Higher cumulative average TyG-WHtR quartiles showed progressively increased CVD incidence (Q1: 7.4%, Q4: 13.3%; P-trend<0.001). After full adjustment, participants in Q2-Q4 had significantly higher CVD risk versus Q1 (Q2: OR=1.451, 95% CI: 1.095-1.928; Q3: OR=1.427, 1.066-1.917; Q4: OR=1.436, 1.035-2.000). Each 1-SD increase in TyG-WHtR was associated with a 18.3% higher CVD risk (OR=1.183, 95% CI: 1.052-1.332). A linear dose-response relationship was observed (P for overall = 0.018, P for nonlinear = 0.409), particularly for heart disease (P for overall = 0.010). Results remained consistent across subgroups (age, sex, smoking, comorbidities) and sensitivity analyses.
conclusionsCumulative average TyG-WHtR independently predicts incident CVD in middle-aged and older Chinese adults. The cumulative average TyG-WHtR index may serve as a potential practical tool for early identification of individuals at elevated cardiovascular risk.
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