Triglyceride glucose-waist circumference dynamics and cardiovascular risk: a national longitudinal study

Cardiovascular disease (CVD) has been documented to be related with the triglyceride glucose (TyG) index. However, limited research has explored the change in the triglyceride glucose-waist circumference (TyG-WC) index in relation to CVD, particularly among individuals with prediabetes and diabetes. Thus, this longitudinal analysis aimed to investigate the association between changes in the TyG-WC and CVD in patients with glucose dysregulation.

This study comprised 2428 individuals with prediabetes and diabetes, sourced from the China Health and Retirement Longitudinal Study (CHARLS) database. Using K-means clustering, three subgroups were identified based on their TyG-WC index trajectories. Additionally, the cumulative TyG-WC index was calculated and divided into tertiles (T1, T2, T3). Proportional hazards models were employed to examine the correlations between TyG-WC trajectories, cumulative TyG-WC tertiles, and the incidence of CVD during the follow-up period. Subgroup analyses were carried out to validate the robustness of the results.

The incidence rates of CVD, cardiac events, and stroke were highest among patients with a high-stable TyG-WC, significantly reduced in the moderate-stable TyG-WC group, and lowest among participants with low-stable TyG-WC (all P for trend < 0.001). After adjusting for confounders, the risk of CVD was significantly associated with the TyG-WC trajectories and the cumulative TyG-WC tertiles. Compared to the low-stable group, the CVD risk for the moderate and high-stable groups were 1.266 (95% confidence interval [CI]: 1.009-1.589) and 1.639 (95% CI: 1.269-2.117), respectively (both P < 0.05). Furthermore, the risk of CVD, stroke, and cardiac events in T2 group and T3 group was significantly higher than that in T1 group (all P < 0.05). ROC curve analysis showed that compared with baseline waist circumference, TyG-WC and TyG, the cumulative TyG-WC demonstrated a relatively higher discriminative ability in assessing CVD.

The changes of TyG-WC are closely related to CVD among individuals with prediabetes and diabetes, which may serve as a novel indicator for the early detection of CVD risk in these populations.