Association of the triglyceride-glucose-HDL-BMI index with advanced cardiovascular-kidney-metabolic syndrome in middle-aged and older adults: A cross-population study
Jian Liu, Chanjuan Luo, Lijuan Liu, Xi Yang, Jingwen LuoBackground
The triglyceride-glucose-HDL-BMI (TyHGB) index combines triglycerides, HDL cholesterol, fasting glucose and BMI, which overlap with components used in cardiovascular-kidney-metabolic (CKM) staging. We examined its cross-sectional association with advanced CKM syndrome in two population-based cohorts.
Methods
We analysed adults aged 45 years or older in two population-based cohorts. Advanced CKM syndrome was defined as stages 3–4. Missing covariates were imputed using random forests. Associations were estimated with multivariable logistic regression, restricted cubic splines and subgroup analyses.
Results
The analytic sample included 12,286 US participants and 17,562 Chinese participants. In the extended clinical-adjustment model (Model 4), each one-unit increase in TyHGB was associated with higher odds of advanced CKM syndrome in the US cohort (OR, 1.18; 95% CI, 1.13–1.22) and Chinese cohort (OR, 1.26; 95% CI, 1.22–1.30). Participants in the highest TyHGB quartile also had higher odds in both cohorts. Spline analyses showed positive, approximately monotonic associations without significant non-linearity.
Conclusions
Higher TyHGB was consistently associated with advanced CKM syndrome in two population-based cohorts. Because TyHGB and CKM staging share metabolic components, the findings describe an epidemiological association rather than independent prediction or additional clinical utility.