Longitudinal increases in obesity- and lipid-related indices (especially TyG-BMI, TyG-WC, CVAI and cumulative METS-VF) were associated with higher incident CVD risk and may provide modest incremental value for risk stratification when added to traditional risk factors, but their discriminative ability is moderate and further validation is required before clinical application.
Over a median 66 months of follow-up, 16.57% of 19,315 initially CVD-free participants in the Jinchang Cohort developed CVD.
The highest change class of every index was significantly associated with increased CVD risk.
The strongest associations with CVD were seen for the highest change classes of TyG-BMI, TyG-WC, and CVAI.
Cumulative indices showed a significant dose-response relationship with CVD incidence.
Changes in CVAI and cumulative METS-VF had the highest predictive ability for CVD among the indices, though discrimination was moderate.
Adding these indices to a model of traditional risk factors significantly improved CVD prediction.
Subgroup analyses were consistent with the main findings.
The authors conclude that further validation is needed before clinical application of these dynamic indices.
This study followed about 19,000 adults in Northwest China who did not have cardiovascular disease at the start, for a median of about five and a half years. The researchers looked at how seven measures combining body size (such as waist, BMI, and visceral fat estimates) and blood lipid/glucose markers changed over time. About 1 in 6 participants (16.6%) developed cardiovascular disease during follow-up. People whose measures rose the most had markedly higher odds of developing cardiovascular disease, roughly four times higher for the combined triglyceride-glucose and BMI or waist measures and for a visceral adiposity index (CVAI), compared with the reference groups. Greater cumulative exposure to these measures was also linked to higher risk in a dose-response pattern. Adding these measures to standard risk factors improved risk prediction statistically, but the predictive ability was only moderate (AUC values around 0.64-0.66). This research suggests that tracking changes in body fat distribution and metabolic markers over time may offer some added information about cardiovascular risk beyond traditional factors. However, it is an observational study, and the authors note the benefit is modest and needs further validation before these measures are used in clinical practice.
You J, Ding W, Wang X, Tang J, Li X, Wang R, et al.. (2026). Association between changes in obesity- and lipid-related indices and the risk of cardiovascular disease: a prospective cohort study in Northwest China.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1975120