Associations of baseline and changes in the triglyceride glucose-weight adjusted waist index and cardiovascular disease risk: evidence from middle-aged and older individuals

Abstract

Background: Existing researches have predominantly focused on the implications of dynamic alterations in the triglyceride-glucose (TyG) index and traditional obesity measures for cardiovascular disease (CVD) risk. However, the application of the weight-adjusted waist index (WWI), which incorporates the dynamically changing body composition factors of weight and waist circumference, alongside the TyG index for predicting CVD risk, remains unexplored. This study explores the relationships between baseline TyG-WWI index and its dynamic changes with CVD risk.

Methods: Subjects were drawn from the China Health and Retirement Longitudinal Study. Logistic regression analyses were conducted to determine the relationships between baseline and longitudinal changes in the TyG-WWI index and CVD risk, quantified through odds ratios (ORs) and 95% confidence intervals (CIs). The robustness of results was confirmed via subgroup analyses and E-values. Additionally, restricted cubic spline and quartile-based methods evaluated the relationships between baseline and cumulative TyG-WWI indices and CVD risk.

Results: Over two survey waves, 613 CVD events were recorded. Analysis using adjusted multivariable models demonstrated a significant relationship between the cumulative TyG-WWI index and increased CVD risk, with an adjusted OR (95% CI) of 1.005 (1.000, 1.009). Class 2 of the TyG-WWI index change showed greater risk of CVD compared to Class 1, with ORs of 1.270 (1.008, 1.605). However, no significant connection was observed between the baseline TyG-WWI index and CVD risk (OR = 1.007, 95% CI: 0.996, 1.019). These findings were corroborated through extensive sensitivity analyses.

Keywords: Baseline; Cardiovascular disease; China Health and Retirement Longitudinal Study; Dynamic changes; Triglyceride-glucose index; Weight-adjusted waist index.

Fig. 1

Flow chart of the study subjects. CVD, cardiovascular disease; FBG, fasting blood glucose; TG, triglyceride

Fig. 2

Categories of change in the TyG-WWI index from Wave 1 to Wave 3. (A) Data visualization for the classes of the change in the TyG-WWI index from Wave 1 to Wave 3. (B) Data distribution of TyG-WWI index in Wave 1 in different classes. C Data distribution of TyG-WWI index in Wave 3 in different classes. TyG: triglyceride-glucose index; WWI: weight-adjusted waist index

Fig. 3

Subgroup analyses of the relationships between cumulative TyG-WWI index and CVD risk. Data are presented as OR (95% CI) unless indicated otherwise. Adjusted for gender, age, educational level, hukou, pulse, total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol, serum uric acid, smoking status, drinking status, history of diabetes, history of hypertension, antidiabetic agents, and antihyperlipidemic agents. The stratified variable was excluded from the model when analyses were stratified by that variable. CI, confidence interval; CVD, cardiovascular disease; OR, odd ratio; TyG, triglyceride-glucose index; WWI, weight- adjusted waist index

Fig. 4

Relative importance of cumulative (A), change (B), and baseline (C) TyG-WWI index in CVD risk. DM, history of diabetes; HDL-C, high-density lipoprotein cholesterol; HTN, history of hypertension; LDL-C, low-density lipoprotein cholesterol; UA, uric acid; TC, total cholesterol; TyG, triglyceride-glucose index; WWI, weight- adjusted waist index