ORIGINAL RESEARCH article

Front. Cardiovasc. Med.

Sec. Atherosclerosis and Vascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1593413

Exploring BMI's Mediating Influence on Cardiovascular Risk Correlations with the Triglyceride-Glucose Index: Using NHANES and CHARLS Cohorts

Provisionally accepted
Yimeng  JiaYimeng Jia1,2Shuo  ZhangShuo Zhang1Junjie  LiuJunjie Liu1,2*
  • 1North China University of Science and Technology, Tangshan, Hebei Province, China
  • 2Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, China

The final, formatted version of the article will be published soon.

Objective: This investigation employed population-based datasets to elucidate the pathophysiological interplay between triglyceride-glucose index (TyG) and incident cardiovascular disease (CVD), and quantify the extent to which body mass index (BMI) operates as a biological mediator within this association, utilizing a dual-cohort analytical framework.In this study, 17,976 Americans from the NHANES(1999-2020) and 6,218 Chinese from the CHARLS(2011-2020) were included. To investigate the intricate link between the TyG index, BMI and CVD, researchers employed weighted multiple logistic regression, linear regression, restricted cubic spline (RCS) analysis, mediation analysis, and subgroup analysis.Results: Among the study population, 1,895 Americans and 1,798 Chinese were diagnosed with cardiovascular disease (CVD). The regression analysis indicated that individuals in the higher quartile of the TyG index had a significantly greater risk of developing CVD (NHANES: P<0.01, 95% CI: 1.11-1.78; CHARLS: P<0.001, 95% CI: 1.37-1.89). In both surveys, participants with elevated TyG indices and BMI levels exhibited the highest incidence of CVD. The TyG index significantly affected CVD in both the NHANES and CHARLS cohorts. The total effect in the NHANES cohort was 1.438×10-3 (P<0.001), and in the CHARLS cohort, it was 0.007 (P<0.001).Conclusions: In this study, two independent cross-sectional cohort studies demonstrated significant positive correlations among TyG, BMI, and CVD. Multivariate analyses identified BMI as a partial mediator in the TyG-CVD pathway, with robust effect magnitudes remaining stable after controlling for age, sex, and other confounders.

Keywords: cardiovascular disease, Triglyceride-glucose index, Body Mass Index, mediation analyses, NHANES, CHARLS

Received: 14 Mar 2025; Accepted: 30 May 2025.

Copyright: © 2025 Jia, Zhang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Junjie Liu, North China University of Science and Technology, Tangshan, 063009, Hebei Province, China

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