Independent association of the CHG index with cardiometabolic multimorbidity: real-world evidence from community and clinical datasets.
4 affiliations
- 1School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, China.
- 2The First School of Clinical Medicine, Xinjiang Medical University, Urumqi, China.
- 3Data Center of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
- 4Department of Heart Function, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Abstract
Background
Cardiometabolic multimorbidity (CMM) is an increasing public health challenge in aging populations. The cholesterol-high-density lipoprotein-glucose (CHG) index is an emerging metabolic marker, but its association with prevalent CMM has not been sufficiently evaluated across community and hospitalized populations. This study examined the association between CHG and CMM using clinical and China Health and Retirement Longitudinal Study (CHARLS) data.Methods
This cross-sectional study included 5,544 hospitalized patients from the First Affiliated Hospital of Xinjiang Medical University and 11,221 community-dwelling participants from CHARLS. CMM was defined as the presence of at least two of heart disease, stroke, and diabetes mellitus. Multivariable logistic regression was used to assess associations between CHG and CMM after adjustment for demographic, lifestyle, and clinical factors. Restricted cubic spline analyses assessed nonlinearity, while receiver operating characteristic curves evaluated discriminative performance. Subgroup and sensitivity analyses were also performed.Results
Each SD increase in CHG was associated with higher odds of prevalent CMM in both the clinical dataset (OR = 1.96, 95% CI: 1.74-2.21) and CHARLS (OR = 4.14, 95% CI: 3.46-4.94). Significant J-shaped nonlinear associations were observed in both datasets. Adding CHG to the basic model improved discrimination, with AUCs of 0.690 and 0.834 in the clinical and CHARLS datasets, respectively. A nominal smoking interaction in the clinical dataset (p for interaction = 0.043) was not significant after false discovery rate correction. Sensitivity analyses were generally consistent with the primary findings. Phenotype-specific analyses were broadly consistent across two-disease combinations in CHARLS, whereas the heart disease-stroke phenotype without diabetes showed a distinct pattern in the clinical dataset.Conclusion
Higher CHG was independently associated with prevalent CMM in hospitalized and community-dwelling middle-aged and older Chinese adults. Nonlinear associations were observed in both datasets, and no subgroup interaction remained significant after multiple-testing correction. CHG may provide a simple, accessible indicator of cardiometabolic burden, with potential value for risk stratification and population-level identification of individuals with greater cardiometabolic disease burden. Derived from routinely available laboratory measures, CHG may complement established cardiometabolic assessment and support population health and integrated chronic disease management in aging populations.
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BibTeX
@article{cui2026independent,
title = {{Independent association of the CHG index with cardiometabolic multimorbidity: real-world evidence from community and clinical datasets.}},
author = {Zexu Cui and Tianhao Lan and Min Lu and Nan Zhang and Donglin Yang and Xahzat Xuhrat and Minghong Kang and Jinglun Kuang and Dilnur Turghun and Tiancai Wen and Ping Fan and Yun Zhao},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1967131},
url = {https://europepmc.org/article/MED/42908644},
note = {CC BY},
}
RIS
TY - JOUR
TI - Independent association of the CHG index with cardiometabolic multimorbidity: real-world evidence from community and clinical datasets.
AU - Zexu Cui
AU - Tianhao Lan
AU - Min Lu
AU - Nan Zhang
AU - Donglin Yang
AU - Xahzat Xuhrat
AU - Minghong Kang
AU - Jinglun Kuang
AU - Dilnur Turghun
AU - Tiancai Wen
AU - Ping Fan
AU - Yun Zhao
PY - 2026
DA - 2026/10/07
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1967131
UR - https://europepmc.org/article/MED/42908644
AB - Background Cardiometabolic multimorbidity (CMM) is an increasing public health challenge in aging populations. The cholesterol-high-density lipoprotein-glucose (CHG) index is an emerging metabolic marker, but its association with prevalent CMM has not been sufficiently evaluated across community and hospitalized populations. This study examined the association between CHG and CMM using clinical and China Health and Retirement Longitudinal Study (CHARLS) data.Methods This cross-sectional study included 5,544 hospitalized patients from the First Affiliated Hospital of Xinjiang Medical University and 11,221 community-dwelling participants from CHARLS. CMM was defined as the presence of at least two of heart disease, stroke, and diabetes mellitus. Multivariable logistic regression was used to assess associations between CHG and CMM after adjustment for demographic, lifestyle, and clinical factors. Restricted cubic spline analyses assessed nonlinearity, while receiver operating characteristic curves evaluated discriminative performance. Subgroup and sensitivity analyses were also performed.Results Each SD increase in CHG was associated with higher odds of prevalent CMM in both the clinical dataset (OR = 1.96, 95% CI: 1.74-2.21) and CHARLS (OR = 4.14, 95% CI: 3.46-4.94). Significant J-shaped nonlinear associations were observed in both datasets. Adding CHG to the basic model improved discrimination, with AUCs of 0.690 and 0.834 in the clinical and CHARLS datasets, respectively. A nominal smoking interaction in the clinical dataset (p for interaction = 0.043) was not significant after false discovery rate correction. Sensitivity analyses were generally consistent with the primary findings. Phenotype-specific analyses were broadly consistent across two-disease combinations in CHARLS, whereas the heart disease-stroke phenotype without diabetes showed a distinct pattern in the clinical dataset.Conclusion Higher CHG was independently associated with prevalent CMM in hospitalized and community-dwelling middle-aged and older Chinese adults. Nonlinear associations were observed in both datasets, and no subgroup interaction remained significant after multiple-testing correction. CHG may provide a simple, accessible indicator of cardiometabolic burden, with potential value for risk stratification and population-level identification of individuals with greater cardiometabolic disease burden. Derived from routinely available laboratory measures, CHG may complement established cardiometabolic assessment and support population health and integrated chronic disease management in aging populations.
SN - 2296-2565
ER -