ArticleFrontiers in cardiovascular medicine2026
Reassessing of the incremental predictive value of triglyceride-glucose index beyond traditional cardiovascular risk factors: a cohort study based on the China health and nutrition survey and meta-analysis.
Article in Frontiers in cardiovascular medicine, 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: This study aims to explore whether incorporating the triglyceride-glucose (TyG) index into the Framingham Risk Score (FRS) can enhance discriminative performance using raw data from the China Health and Nutrition Survey (CHNS) cohort, and to systematically quantify its incremental predictive value through a meta-analysis. Methods: Participants were adults aged 45 to 80 years without baseline cardiovascular disease (CVD). Incident CVD was defined as new diagnoses of myocardial infarction or stroke. Cox regression was used to examine the association between TyG and CVD, and the results were expressed as hazard ratios (HR) with 95% confidence intervals (CI). While the incremental predictive value of TyG added to FRS was assessed via C-index, integrated discrimination improvement (IDI) and net reclassification improvement (NRI). Restricted cubic splines in Poisson models explored non-linearity. For the meta-analysis, we included effect estimates for the incremental value of the TyG index. Results: The highest TyG quartile was significantly associated with higher risks of CVD (HR = 2.073; 95% CI: 1.233 to 3.488) and stroke (HR = 2.078; 95% CI: 1.428 to 5.521), with a non-linear dose-response relationship ( Conclusions: While the TyG index shows a significant statistical association with CVD risk, its incremental predictive value beyond established FRS factors is minimal at the cohort level and negligible at the meta-analytic level. These findings suggest that the TyG index, despite being a significant risk marker, may not materially improve the predictive performance of existing cardiovascular risk scores.
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