Association of the triglyceride glucose-Chinese visceral adiposity index with incident cardiometabolic multimorbidity in middle-aged and older adults: a nationwide prospective cohort study.

Baseline TyG-CVAI showed a graded, positive association with incident cardiometabolic multimorbidity risk.

• Cohort 1 consisted of 8,895 patients from the China Health and Retirement Longitudinal Study (CHARLS).
• 875 incident CMM cases were documented in Cohort 1 during follow-up.
• Compared with the lowest quartile, the highest quartile of baseline TyG-CVAI was associated with a significantly increased CMM risk (HR = 1.93, 95% CI = 1.46–2.54).
• A significant nonlinear relationship with threshold effects was observed (P for nonlinearity < 0.001).

Cumulative TyG-CVAI showed a graded, positive association with incident cardiometabolic multimorbidity risk.

• Cohort 2 consisted of 5,839 patients, with cumulative TyG-CVAI calculated as the average TyG-CVAI between baseline and the 2015 wave multiplied by the exposure time.
• 492 incident CMM cases were documented in Cohort 2 during follow-up.
• Compared with the lowest quartile, the highest quartile of cumulative TyG-CVAI was associated with a significantly increased CMM risk (HR = 1.76, 95% CI = 1.22–2.53).
• A significant nonlinear relationship with threshold effects was observed (P for nonlinearity < 0.001).

Both baseline and cumulative TyG-CVAI demonstrated superior predictive ability for CMM compared with their individual components (TyG or CVAI alone).

• Predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis.
• Both the baseline and cumulative TyG-CVAI had a larger area under the ROC curve than either TyG or CVAI individually.
• Cox regression models were used to estimate hazard ratios, with nonlinearity assessed using restricted cubic splines.

Incident CMM was ascertained using a combination of self-reported physician diagnosis, medication use, and clinical data in a nationwide prospective cohort design.

• Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide prospective cohort.
• Two separate cohorts were constructed: Cohort 1 for baseline TyG-CVAI analysis and Cohort 2 for cumulative TyG-CVAI analysis.
• The study population comprised middle-aged and older adults.
• CMM was confirmed via self-reported physician diagnosis, medication use, and clinical data.

Cardiometabolic multimorbidity is identified as a growing global health challenge for which early risk stratification tools are needed.

• TyG-CVAI is described as an 'easily obtainable metric' that 'may enhance risk stratification and help identify high-risk individuals for early preventive intervention.'
• Prior to this study, whether baseline or cumulative TyG-CVAI could predict incident CMM remained unclear.
• The TyG-CVAI combines the triglyceride glucose index with the Chinese visceral adiposity index.