ArticleFrontiers in nutrition2026
Cholesterol, high-density lipoprotein, and glucose (CHG) index and incident impaired fasting glucose in Chinese adults: a retrospective longitudinal cohort study.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Diabetes mellitus poses a critical global public health burden, with impaired fasting glucose (IFG) being a crucial prediabetic state requiring early identification. The cholesterol, high-density lipoprotein, and glucose (CHG) index, a novel composite marker integrating TC, HDL-C, and FPG, has shown promise in assessing cardiometabolic risk. However, longitudinal evidence on its association with incident IFG, particularly in populations with normal baseline FPG, remains limited. This study aimed to evaluate the independent association between the baseline CHG index and the risk of incident IFG in Chinese adults. Methods: This retrospective longitudinal cohort study utilized data from 100,802 Chinese adults with normal baseline FPG, derived from a publicly available health screening cohort. The exposure was the baseline CHG index. The primary outcome was new-onset IFG. Multivariable Cox proportional hazards regression models were constructed to assess the association. Restricted cubic splines (RCS) were applied to explore potential nonlinearity, and subgroup analyses were conducted to evaluate the consistency of the association across different populations. Results: Over the follow-up period, 12,414 participants (12.32%) developed IFG. After full adjustment for covariates including demographic, anthropometric, clinical, and lifestyle factors, each one-unit increase in the CHG index was associated with a significantly increased risk of incident IFG. A clear dose-response relationship was observed across CHG index quartiles. RCS analysis revealed a significant nonlinear association with an inflection point at a CHG index of 5.259. Below this threshold, the risk increased sharply, while the association was attenuated and non-significant above it. This positive association remained consistent across all predefined subgroups. Conclusion: A higher baseline CHG index is an independent and strong predictor of incident IFG in Chinese adults with normal fasting glucose, exhibiting a nonlinear threshold relationship. The CHG index, easily calculated from routine lipid and glucose tests, may serve as a practical and economical tool for the early identification of individuals at high risk for prediabetes, informing targeted prevention strategies.
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