{
  "abstract": "Background\n\nThe triglyceride-glucose index (TyG) and frailty index (FI) reflect metabolic dysregulation and multisystem vulnerability, respectively. However, the associations of the combined triglyceride-glucose index and frailty index (TyG-FI), its cumulative exposure, and two-wave patterns with progression from cardiovascular-kidney-metabolic (CKM) syndrome stages 0-2 to stages 3-4 and stage 4 remain unclear.Methods\n\nThis CHARLS cohort study included 3,473 adults with CKM stages 0-2 at Wave 1 and repeat exposure and outcome assessments at Wave 3. TyG-FI was calculated as TyG × FI. Estimated cumulative TyG-FI combined the two measurements and their time interval; K-means clustering identified three two-wave patterns. Cox regression evaluated baseline TyG-FI, and logistic regression evaluated cumulative exposure and two-wave patterns. Discrimination, internal K-fold cross-validation, and sensitivity analyses were assessed.Results\n\nAt Wave 3, 319 participants met CKM stage 4 criteria and 975 met CKM stages 3-4 criteria. In fully adjusted models, baseline TyG-FI was associated with stage 4 (HR per SD, 1.33; 95% CI, 1.20-1.47) and stages 3-4 (HR, 1.10; 95% CI, 1.03-1.18). The corresponding ORs for estimated cumulative TyG-FI were 1.83 (95% CI, 1.62-2.06) and 1.42 (95% CI, 1.29-1.56); highest-versus-lowest-tertile ORs were 12.40 (95% CI, 7.43-20.67) and 2.38 (95% CI, 1.86-3.04). TyG-FI pattern Class 3 was associated with stage 4 (OR, 5.93; 95% CI, 3.88-9.07) and stages 3-4 (OR, 2.30; 95% CI, 1.67-3.17). Spline associations were nonlinear. Baseline TyG-FI AUCs were 0.67 and 0.57 for the respective endpoints, with similar performance to FI.Conclusions\n\nHigher baseline TyG-FI was associated with subsequent CKM progression, while cumulative TyG-FI and two-wave patterns were associated with progression status at follow-up. TyG-FI may provide an accessible composite measure for identifying individuals with early CKM syndrome who are at increased risk of advanced-stage progression.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Jiujiang City Key Laboratoryof Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China.",
    "Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yan Jiang West Road, Guangzhou, 510120, China.",
    "The First Affiliated Hospital, Sun Yat‑sen University, Guangzhou, 510120, China.",
    "Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yan Jiang West Road, Guangzhou, 510120, China. zhoujing23@mail.sysu.edu.cn.",
    "Department of Cardiology, Jiujiang City Key Laboratoryof Cell Therapy, JiuJiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China. 18720060090@163.com.",
    "Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yan Jiang West Road, Guangzhou, 510120, China. 18720060090@163.com."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hailan Xiong"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Yushan Lei"
    },
    {
      "affs": [
        3
      ],
      "name": "Jing Zhou"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Jiawang Zou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bazz44w30kytj.bib",
  "cited_by": 0,
  "doi": "10.1186/s12933-026-03411-w",
  "fulltext_url": "https://europepmc.org/articles/PMC13721612",
  "id": "bazz44w30kytj",
  "issns": [
    "1475-2840"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958256",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2712|Diabetes, Cardiovascular Risks, and Lipoproteins"
    ]
  ],
  "openalex": "W7222427509",
  "pdf_url": "https://europepmc.org/articles/PMC13721612?pdf=render",
  "pmcid": "PMC13721612",
  "pmid": "42958256",
  "published": "2026-10-16",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/bazz44w30kytj.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:21Z",
      "native_id": "MED:42958256",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958256"
    },
    {
      "first_seen": "2026-11-03T12:22:16Z",
      "native_id": "PMC13721612",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12933-026-03411-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Associations of baseline levels, cumulative exposure, and two-wave patterns of the combined triglyceride-glucose index and frailty index with progression from cardiovascular-kidney-metabolic syndrome stages 0-2 to stages 3-4 and stage 4: a prospective cohort study from CHARLS.",
  "title_text": "Associations of baseline levels, cumulative exposure, and two-wave patterns of the combined triglyceride-glucose index and frailty index with progression from cardiovascular-kidney-metabolic syndrome stages 0-2 to stages 3-4 and stage 4: a prospective cohort study from CHARLS.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:16Z",
  "url": "https://research.draconitic.com/paper/bazz44w30kytj",
  "venue": "Cardiovascular diabetology",
  "versions": []
}