ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Longitudinal TyG–BMI Trajectories Predict Carotid Atherosclerosis Progression in a Chinese Retrospective Cohort
Provisionally accepted
- Ningbo Medical Centre Lihuili Hospital, Ningbo, China
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Carotid atherosclerosis (CAS) is a major precursor of ischemic stroke, underscoring the importance of early identification of reliable metabolic risk markers. Insulin resistance and metabolic dysfunction are recognized as key contributors to CAS development, and the triglyceride-glucose body mass index (TyG–BMI) has emerged as a promising surrogate biomarker. In this retrospective cohort study, we analyzed 2,329 Chinese adults who underwent serial health examinations, with a median follow-up of 1,826 days. Using latent class trajectory modeling, two distinct TyG–BMI trajectories were identified: stable (Class 1) and rising (Class 2). CAS progression was observed in 46% of participants, with a higher incidence in the rising trajectory group (52.9% vs. 39.9%). Multivariable Cox regression showed that a rising TyG–BMI trajectory was independently associated with an increased risk of CAS progression (adjusted HR = 1.19, 95% CI: 1.04–1.36), particularly among younger adults (≤50 years, HR = 2.04) and women (HR = 1.88). Sensitivity analyses confirmed robustness. Extended prediction models incorporating trajectories demonstrated good calibration, higher discrimination, and greater clinical net benefit in decision curve analysis. These findings underscore the value of dynamic TyG–BMI monitoring in vascular risk stratification and targeted prevention. To our knowledge, this is the first large-scale study to establish the predictive value of longitudinal TyG–BMI trajectories for CAS progression in a Chinese population.
Keywords: carotid atherosclerosis, TyG–BMI, Insulin Resistance, cardiovascular risk, trajectory analysis, cohort study
Received: 24 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Wang, Xu, Zhang, Peng, Li and Ye. 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: Honghua Ye, lhlyehonghua@nbu.edu.cn
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