Differential associations of baseline, dynamic change, and cumulative average TyG-BMI with incident cardiometabolic multimorbidity: a longitudinal landmark analysis of CHARLS
Abstract
Cardiometabolic multimorbidity (CMM) is common, yet the prognostic relevance of temporal triglyceride-glucose body mass index (TyG-BMI) measures remains unclear. A 2015 landmark analysis of the China Health and Retirement Longitudinal Study included 4597 participants. Baseline TyG-BMI was measured in 2011; dynamic change and cumulative average were derived from 2011 and 2015 measurements. Incident CMM was ascertained during 2015–2020. Discrete-time complementary log–log models estimated associations, with supplementary analyses of the 2015 landmark value, disease transitions, component outcomes, and bootstrap validation. Overall, 528 participants developed CMM. Baseline and cumulative average TyG-BMI were associated with CMM (HR per 1-SD increase 1.28, 95% CI 1.17–1.40; and 1.25, 95% CI 1.14–1.37, respectively), with linear dose–response patterns. Dynamic change was not independently associated after baseline adjustment (HR 0.96, 95% CI 0.89–1.04). The 2015 landmark value was also associated with CMM (HR 1.19, 95% CI 1.09–1.30), and residualized cumulative average remained associated after accounting for this value (HR 1.17, 95% CI 1.08–1.27). Among cases with complete landmark disease status, 80.7% had one existing condition; baseline and cumulative average associations extended across all three components and CMM transitions with or without newly acquired diabetes. Bootstrap-corrected improvement beyond the 2015 value was small (ΔAUC 0.004, 95% CI − 0.0002 to 0.0076). Baseline, current, and cumulative average TyG-BMI identified higher CMM risk, whereas short-term change added little information. TyG-BMI may complement clinical risk assessment, but its added predictive value was modest.
Related
- Associations of cumulative exposure and dynamic trajectories of the combined estimated glucose disposal rate and frailty index with incident cardiometabolic multimorbidity comprising diabetes, heart disease, and stroke: a longitudinal analysis based on the China health and retirement longitudinal study (CHARLS)
- Associations of cumulative exposure and dynamic trajectories of the combined atherogenic-frailty index with incident cardiometabolic multimorbidity: a prospective cohort study.
- Estimated glucose disposal rate shows the broadest associations with cardiometabolic multimorbidity progression in early cardiovascular–kidney–metabolic stages: a longitudinal cohort study
- Body Roundness Index Predicts Incident Cardiometabolic-depression Multimorbidity: A Dose-response Analysis of 19,802 Adults in China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing Cohorts
- Longitudinal joint trajectories of the dietary inflammatory index and physical activity and risk of incident cardiometabolic multimorbidity among women: evidence from the China Health and Nutrition Survey
BibTeX
@article{wu2026differential,
title = {{Differential associations of baseline, dynamic change, and cumulative average TyG-BMI with incident cardiometabolic multimorbidity: a longitudinal landmark analysis of CHARLS}},
author = {Zizheng Wu and Chenjie Guo and Jianguo Li},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-73100-x},
url = {https://www.nature.com/articles/s41598-026-73100-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Differential associations of baseline, dynamic change, and cumulative average TyG-BMI with incident cardiometabolic multimorbidity: a longitudinal landmark analysis of CHARLS
AU - Zizheng Wu
AU - Chenjie Guo
AU - Jianguo Li
PY - 2026
DA - 2026/10/22
JO - Scientific Reports
DO - 10.1038/s41598-026-73100-x
UR - https://www.nature.com/articles/s41598-026-73100-x
AB - Cardiometabolic multimorbidity (CMM) is common, yet the prognostic relevance of temporal triglyceride-glucose body mass index (TyG-BMI) measures remains unclear. A 2015 landmark analysis of the China Health and Retirement Longitudinal Study included 4597 participants. Baseline TyG-BMI was measured in 2011; dynamic change and cumulative average were derived from 2011 and 2015 measurements. Incident CMM was ascertained during 2015–2020. Discrete-time complementary log–log models estimated associations, with supplementary analyses of the 2015 landmark value, disease transitions, component outcomes, and bootstrap validation. Overall, 528 participants developed CMM. Baseline and cumulative average TyG-BMI were associated with CMM (HR per 1-SD increase 1.28, 95% CI 1.17–1.40; and 1.25, 95% CI 1.14–1.37, respectively), with linear dose–response patterns. Dynamic change was not independently associated after baseline adjustment (HR 0.96, 95% CI 0.89–1.04). The 2015 landmark value was also associated with CMM (HR 1.19, 95% CI 1.09–1.30), and residualized cumulative average remained associated after accounting for this value (HR 1.17, 95% CI 1.08–1.27). Among cases with complete landmark disease status, 80.7% had one existing condition; baseline and cumulative average associations extended across all three components and CMM transitions with or without newly acquired diabetes. Bootstrap-corrected improvement beyond the 2015 value was small (ΔAUC 0.004, 95% CI − 0.0002 to 0.0076). Baseline, current, and cumulative average TyG-BMI identified higher CMM risk, whereas short-term change added little information. TyG-BMI may complement clinical risk assessment, but its added predictive value was modest.
SN - 2045-2322
ER -