[Association between triglyceride glucose index combined with obesity index and cardiovascular disease risk in middle-aged and old adults in China].

High levels of TyG index were significantly associated with increased CVD risk in middle-aged and older Chinese adults.

• Study population: 6,158 middle-aged and older adults without CVD at baseline from the China Health and Retirement Longitudinal Study (2011–2020).
• 1,639 CVD events occurred during the 9-year follow-up period.
• Compared with Q1, the HR for TyG in Q4 was 1.36 (95%CI: 1.19–1.57) after adjusting for confounding factors.
• RCS analysis showed a linear association between TyG and CVD risk.

TyG-BMI showed the strongest association with CVD risk among all composite metabolic indexes examined.

• Compared with Q1, the HR for TyG-BMI in Q4 was 1.74 (95%CI: 1.51–2.01).
• This was the highest hazard ratio among the four indexes evaluated (TyG, TyG-BMI, TyG-WHtR, TyG-WWI).
• RCS analysis showed a linear association between TyG-BMI and CVD risk.
• Cox proportional hazard regression was used with adjustment for confounding factors.

TyG-waist-to-height ratio (TyG-WHtR) was significantly associated with CVD risk in a non-linear fashion.

• Compared with Q1, the HR for TyG-WHtR in Q4 was 1.55 (95%CI: 1.34–1.79).
• RCS analysis revealed a non-linear association between TyG-WHtR and CVD risk.
• This differed from TyG and TyG-BMI, which showed linear associations.

TyG-weight-adjusted-waist index (TyG-WWI) was significantly associated with CVD risk in a non-linear fashion.

• Compared with Q1, the HR for TyG-WWI in Q4 was 1.38 (95%CI: 1.20–1.60).
• RCS analysis showed a non-linear association between TyG-WWI and CVD risk.
• The association pattern was similar to TyG-WHtR (both non-linear) and distinct from TyG and TyG-BMI (both linear).

The associations between TyG-based composite indexes and CVD risk were consistent across subgroups defined by age, sex, education level, and hypertension status.

• Subgroup analyses were conducted by age, sex, education level, and hypertension status.
• All P values for interaction were >0.05, indicating no statistically significant effect modification.
• The authors concluded that associations were 'in good agreement' across all subgroups tested.

The study used data from the China Health and Retirement Longitudinal Study spanning 2011 to 2020 with a 9-year follow-up.

• 6,158 middle-aged and older adults without CVD at baseline were included.
• Cox proportional hazard regression model was the primary analytical method.
• Kaplan-Meier curves and restricted cubic spline (RCS) analysis were used to explore dose-response relationships and nonlinear trends.
• Four indexes were evaluated: TyG, TyG-BMI, TyG-WHtR, and TyG-WWI.