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. 2025 Jun 19;24(1):218.
doi: 10.1186/s12944-025-02643-1.

Triglyceride-glucose index and its related factors may be predictors for cardiovascular disease among Chinese postmenopausal women: a 12-year cohort study

Weiyan Tu #  1 , Rongdi Xu #  2 , Dan Wang  3 , Na Luo  3 , Meijing Wu  3 , Yong Zhou  4 , Jing Ning  5
Affiliations

Triglyceride-glucose index and its related factors may be predictors for cardiovascular disease among Chinese postmenopausal women: a 12-year cohort study

Weiyan Tu et al. Lipids Health Dis. .

Abstract

Background: This study investigated and compared the abilities of the triglyceride glucose index (TyG) and its correlated factors involving TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), and TyG-waist circumference (TyG-WC) to predict cardiovascular disease (CVD) among Chinese postmenopausal women. This topic has not been adequately explored in the existing literature.

Methods: This prospective study included 1110 Chinese postmenopausal women, stratified into the CVD group and the non-CVD group. The TyG index and its correlated components (TyG, TyG-BMI, TyG-WHtR, and TyG-WC) were calculated. The primary endpoint was CVD.

Results: Across a 12-year follow-up period, 76 (6.84%) CVDs were documented. The TyG index, in collaboration with various indicators of obesity, demonstrated a robust positive correlation with the risk of CVD. In comparison to other TyG indices, TyG-WC was the strongest predictor for CVD (HR: 2.61, 95%CI:1.64-4.14; P < 0.001), and the TyG-WHtR index exhibited the strongest diagnostic value in identifying CVD (AUC: 0.632, 95%CI: 0.603-0.660; P < 0.001). Incorporating TyG-WHtR into the base model significantly enhanced incremental risk stratification for CVD (NRI: 0.115, 95%CI: 0.040-0.190, P < 0.05; AIC: 996; BIC: 1041; Harrell's C-index: 0.73). Decision curve analysis (DCA) suggested that TyG, TyG-WHtR, and TyG-WC can provide significant clinical benefits for Chinese postmenopausal women. The sensitivity analyses have demonstrated the robustness of these results.

Conclusions: The TyG index and its correlated factors can effectively predict CVD in Chinese postmenopausal women. TyG-WHtR has the most potent ability to predict CVD among postmenopausal women.

Keywords: Cardiovascular disease; Postmenopausal women; Prospective study; The TyG WHtR index; The TyG index; The TyG-BMI index; The TyG-WC index.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: The study was conducted following the principles of the Helsinki Declaration and received approval from the Ethics Committees of Kailuan General Hospital, Beijing Tongren Hospital, and Beijing Tiantan Hospital. This approval is to be renewed every five years. Written informed consent was secured from all participants involved in the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart depicting the selection of participants
Fig. 2
Fig. 2
Incidence of CVD based on the cutoff values of TyG and its relevant factors among postmenopausal women
Fig. 3
Fig. 3
Kaplan-Meier curves for CVD based on the cut-off of TyG index (A), TyG-WC (B), TyG WHtR (C), TyG-BMI (D) in the postmenopausal population
Fig. 4
Fig. 4
Restricted cubic spine curves for the association of TyG (A), TyG-WC (B), TyG-WHtR (C), and TyG-BMI (D) with the risk of CVD among the postmenopausal population in the adjusted model
Fig. 5
Fig. 5
Decision curve analysis curves for the association of different models with the risk of CVD among the postmenopausal population. The base model was adjusted for age, education level, smoking, hypertension, diabetes, dyslipidemia, creatinine, and hs-CRP
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