{
  "abstract": "Background\n\nCardiovascular-liver-metabolic multimorbidity (CLMM), defined as the co-occurrence of at least two of cardiovascular disease, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease, is an increasing health burden. We evaluated the cholesterol, high-density lipoprotein, and glucose (CHG) index and its obesity- and inflammation-derived variants for predicting incident CLMM.Methods\n\nThis prospective cohort included 6,534 adults aged ≥45 years from the China Health and Retirement Longitudinal Study. CHG, eight obesity-derived indices, and CHG-CRP were assessed, with the triglyceride-glucose index and TG/HDL-C ratio as comparators. Associations with incident CLMM were evaluated using logistic regression, restricted cubic splines, and threshold analysis. Predictive performance was compared using receiver operating characteristic analysis, the integrated discrimination improvement (IDI), and the net reclassification improvement (NRI), with additional joint-effect, interaction, subgroup, and sensitivity analyses.Results\n\nAt the 2015 follow-up, 406 participants (6.2%) met the criteria for CLMM. Higher CHG was linearly associated with incident CLMM (highest vs lowest quartile: OR 1.64, 95% confidence interval [CI] 1.22-2.22). Obesity-derived variants showed stronger associations, particularly CHG-BMI (OR 3.13, 95% CI 2.21-4.43), which also had the highest discrimination (AUC 0.643, 95% CI 0.616-0.669) and continuous NRI (34.08%). Participants with both high CHG and high BMI had the greatest CLMM risk (OR 2.59, 95% CI 1.94-3.51). Results were robust in sensitivity analyses.Conclusions\n\nThe CHG index and its obesity-derived variants, particularly CHG-BMI, are accessible and inexpensive candidate metabolic markers for predicting new-onset CLMM. CHG-BMI showed the highest apparent discrimination among the evaluated indices, although its AUC was modest. External population validation is needed.",
  "abstract_shown": true,
  "affiliations": [
    "Medical School of Nanjing University, Nanjing, China.",
    "Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.",
    "Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.",
    "Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.",
    "Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhonghua Sun"
    },
    {
      "affs": [
        1
      ],
      "name": "Aikeliyaer Ainiwaer",
      "orcid": "0000-0002-4846-8791"
    },
    {
      "affs": [
        2
      ],
      "name": "Yameng Xu"
    },
    {
      "affs": [
        3
      ],
      "name": "Ge Zhang",
      "orcid": "0000-0002-3116-3246"
    },
    {
      "affs": [
        4
      ],
      "name": "Xiangyu Sun"
    },
    {
      "affs": [
        4
      ],
      "name": "Xinliang Peng",
      "orcid": "0009-0001-9110-2429"
    },
    {
      "affs": [
        4
      ],
      "name": "Yuanhui Dai"
    },
    {
      "affs": [
        4
      ],
      "name": "Kaisaierjiang Kadier",
      "orcid": "0000-0002-1178-4854"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dnc2xsg8vbxv2.bib",
  "cited_by": 0,
  "doi": "10.1111/jdi.70462",
  "fulltext_url": "https://europepmc.org/articles/PMC13651581",
  "id": "dnc2xsg8vbxv2",
  "issns": [
    "2040-1116",
    "2040-1124"
  ],
  "landing_url": "https://europepmc.org/article/MED/42852842",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetes, Cardiovascular Risks, and Lipoproteins"
    ]
  ],
  "openalex": "W7221118418",
  "pdf_url": "https://europepmc.org/articles/PMC13651581?pdf=render",
  "pmcid": "PMC13651581",
  "pmid": "42852842",
  "published": "2026-10-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dnc2xsg8vbxv2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:02Z",
      "native_id": "MED:42852842",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42852842"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "The cholesterol, high-density lipoprotein, and glucose index and its derivatives related to obesity and inflammation as novel metabolic markers for predicting new-onset cardiovascular-liver-metabolic multimorbidity: A prospective cohort study.",
  "title_text": "The cholesterol, high-density lipoprotein, and glucose index and its derivatives related to obesity and inflammation as novel metabolic markers for predicting new-onset cardiovascular-liver-metabolic multimorbidity: A prospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/dnc2xsg8vbxv2",
  "venue": "Journal of diabetes investigation",
  "versions": []
}