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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Cardiovascular Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1687289

This article is part of the Research TopicMetabolic and Inflammatory Pathways in Cardiometabolic Diseases: From Nutritional Interventions to Clinical ApplicationsView all articles

TyG × Waist Circumference Composite Indicator and Cardiovascular Disease Risk in Older Adults Across Multiple Regions: A Cross-Sectional Study

Provisionally accepted
Ying  GuoYing Guo1Jietao  ZhangJietao Zhang2Tong  ChenTong Chen2Yan  WangYan Wang2Fanqi  GengFanqi Geng2Hongjian  JiaHongjian Jia2*
  • 1Affiliated Hospital of Jining Medical University, Jining, China
  • 2The Affiliated Hospital of Qingdao University, Qingdao, China

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

Abstract Objective: To investigate the association between the triglyceride-glucose index combined with waist circumference (TyG×WC) and cardiovascular disease (CVD) risk in older adults across multiple populations. Methods: This study utilized data from three population sources: NHANES (2011–2018), a Chinese community cohort, and a tertiary hospital, enrolling a total of 3,443 eligible older adults. The resulting TyG×WC values were standardized using z-score normalization and subsequently categorized into quartiles. Cardiovascular disease (CVD) status was used as the outcome variable. Multivariable logistic regression models were constructed to evaluate the association between TyG×WC and CVD risk. Trend tests and subgroup analyses by sex and region were also performed. Model performance was assessed using receiver operating characteristic (ROC) curves, the DeLong test, net reclassification improvement (NRI), integrated discrimination improvement (IDI), Brier score, and 10-fold cross-validation. Clinical utility was evaluated through decision curve analysis (DCA), while E-value analysis was used to estimate the potential impact of unmeasured confounding. The trend effect across the three populations was synthesized using random-effects meta-analysis to assess heterogeneity. Results: A total of 3,443 participants were included: 1,684 from NHANES (48.91%), 1,263 hospitalized patients from a tertiary hospital (36.68%), and 496 from a community cohort (14.41%). Multivariable logistic regression indicated a significant positive association between the TyG×WC index and CVD risk. After adjusting for confounders, participants in Q3 and Q4 had significantly higher CVD risk, with a significant linear trend. Subgroup analyses showed a stronger predictive effect in femalesand in the NHANES population. Heterogeneity analysis revealed no significant differences across regions. Regarding model performance, the extended model including TyG×WC showed an improvement in AUC, along with significant improvements in NRI , IDI , and favorable DCA results. The E-value analysis indicated robust results against unmeasured confounding. Conclusion: The TyG×WC composite indicator is an independent predictor of CVD risk, with more pronounced effects observed in women and the general population. This indicator may serve as a valuable tool for screening high-risk individuals and guiding CVD prevention strategies.

Keywords: triglyceride–glucose index (TyG index), Waist Circumference, cardiovascular disease, elderly population, Insulin Resistance, risk prediction

Received: 17 Aug 2025; Accepted: 07 Oct 2025.

Copyright: © 2025 Guo, Zhang, Chen, Wang, Geng and Jia. 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: Hongjian Jia, jhj200018@163.com

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