Triglyceride-glucose-related indices and risk of cardiovascular disease and mortality in individuals with cardiovascular–kidney–metabolic (CKM) syndrome stages 0–3: a prospective cohort study of 282,920 participants in the UK Biobank

Jul 10, 2025Cardiovascular diabetology

Blood fat and sugar-related measures linked to heart disease and death risk in people with early to moderate cardiovascular, kidney, and metabolic problems

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Abstract

During a median follow-up of 13.6 years, 27,134 overall cardiovascular disease (CVD) cases were recorded among 282,920 participants with cardiovascular-kidney-metabolic () syndrome.

  • Higher quartiles of triglyceride-glucose ()-related indices are associated with an increased risk of overall CVD, with hazard ratios ranging from 1.30 to 1.58 for the highest quartile compared to the lowest.
  • The TyG-body mass index (BMI), TyG-waist circumference (WC), and TyG-waist-to-height ratio (WHtR) show consistent positive associations with all-cause and cardiovascular mortality.
  • For all-cause mortality, hazard ratios for the highest versus lowest quartiles of TyG-BMI, TyG-WC, and TyG-WHtR were 1.11, 1.24, and 1.18, respectively.
  • Nonlinear associations between TyG-related indices and overall CVD were observed, particularly for TyG-WC and TyG-BMI, while cardiovascular mortality showed predominantly linear associations.
  • Integrating TyG indices with obesity measures may enhance predictive performance for prognostic outcomes in CKM syndrome patients.

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Key numbers

1.58×
Increase in CVD risk
Hazard ratio for overall CVD in highest vs. lowest -WC quartile.
1.24
Increase in all-cause mortality risk
Hazard ratio for all-cause mortality in highest vs. lowest -WC quartile.
282,920
Study population size
Total number of participants analyzed in the study.

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