ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Associations of cholesterol, high-density lipoprotein and glucose index and triglyceride ‒ glucose-related indices with carotid atherosclerosis in young and middle-aged individuals
Kexin Du 1
Yiping Zhang 1
Xuefei Zhang 1
Yuxin Pan 1
Tao Pan 2
Yuexuan Tong 1
Xiao Chen 1
Dongling Lv 1
1. Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
2. Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China
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Abstract
Background: Associations of cholesterol, high-density lipoprotein, and glucose (CHG) index and triglyceride-glucose (TYG)-related indices are biomarkers of insulin resistance. However, the relationships between carotid atherosclerosis and the CHG index and TYG-related indices in young and middle-aged people are unclear. This cross-sectional study reported such associations in a general population. Methods: A total of 9,110 participants aged between 18 and 60 years were included. TYG index (ln(triglyceride (mg/dL) × blood glucose (mg/dL)/2), TYG-BMI index (TYG×BMI), TYG/HDL index (TYG/HDL cholesterol), and CHG index (ln[cholesterol (mg/dL) × blood glucose (mg/dL)/2 × HDL (mg/dL)) were calculated. The associations between carotid atherosclerosis and CHG- and TYG-related indices were analyzed via logistic regression analyses. Results: Carotid atherosclerosis was observed in 3,089 (33.9%) participants. CHG index was significantly associated with carotid atherosclerosis (odds ratio (OR): 2.47, 95% confidence interval (CI): 1.87–3.26; Q4 vs. Q1, OR: 1.79, 95% CI: 1.42–2.26). Similar associations were observed for the TYG index (OR: 1.26, 95% CI: CI: 1.08–1.48; Q4 vs. Q1, OR: OR: 1.32, 95% CI: 1.08–1.62), TY-BMI (OR: 1.01, 95% CI: 1.00–1.02; Q4 vs. Q1, OR: 1.55, 95% CI: 1.15–2.11) and TYG/HDL (OR: 1.10, 95% CI: 1.06–1.13; Q4 vs. Q1, OR: 1.60, 95% CI: 1.32–1.94). CHG had better performance than the TYG, TYGBMI, and TYGHDL in identifying carotid atherosclerosis (the area under the curve was 0.642 vs 0.599, 0.620, and 0.612, respectively). Conclusion: CHG index and TYG-related indices were associated with carotid atherosclerosis in young and middle-aged individuals. CHG had better performance than did TYG-related indices in identifying carotid atherosclerosis.
Summary
Keywords
and glucose index, carotid atherosclerosis, Cholesterol, high-density lipoprotein, triglyceride-glucose, Young and middle-aged population
Received
19 December 2025
Accepted
19 February 2026
Copyright
© 2026 Du, Zhang, Zhang, Pan, Pan, Tong, Chen and Lv. 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: Xiao Chen; Dongling Lv
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