Background: Previous studies has shown a significant relationship between baseline triglyceride-glucose (TyG) index and cardiovascular disease (CVD). However, the long-term effect of TyG index and incident CVD remains uncertain. This study aimed to investigate the association between cumulative TyG index and the risk of CVD. Method: In this study, we recruited individuals participating in Kailuan Study from 2006 to 2013 without stroke, myocardial infarction, and cancer in the four consecutive examinations. Cumulative TyG index was calculated by multiplying the average TyG index and the time between the two consecutive examinations. Cumulative TyG index levels were categorized into four quartile groups: Q1 group, ≤ 50.65 (as reference group), Q2 group, 50.65–53.86, Q3 group, 53.86–57.44, Q4 group, > 57.44. The association between cumulative TyG index and the risk of CVD was estimated by multivariable Cox proportional hazard models. Result: A total of 44,064 individuals participated in the final analysis. After a mean follow-up of 6.52 ± 1.14 years, incident CVD, MI and stroke occurred in 2057, 395 and 1695, respectively. The risk of developing CVD increased with the quartile of cumulative in TyG index, after adjustment for multiple potential confounders, the HR for CVD events were 1.25 (1.08–1.44) in Q2, 1.22 (1.05–1.40) in Q3 and 1.39 (1.21–1.61) in Q4, compared to Q1 group. The longer duration of higher TyG index exposure was significantly associated with increased CVD risk. Similar results were obtained in the subgroup and sensitivity analysis. Conclusion: Cumulative TyG index was associated with increased risk of CVD. Maintaining an appropriate level of TG and FBG within the desirable range and better control of cumulative TyG index are important for prevention of CVD.

Background: Previous studies have demonstrated that metabolic score for visceral fat (METS‐VF), a novel surrogate indicator assessing visceral fat, was associated with the risk of hypertension, diabetes mellitus, cardiovascular disease (CVD) and mortality, predicting the risks based on a single METS‐VF measurement can increase limitations of the study. Few studies have investigated the association between cumulative exposure to METS‐VF and risk of CVD and all‐cause mortality. We aimed to examine the association of cumulative METS‐VF with risk for CVD and all‐cause mortality. Methods: All participants in the study were from the Kailuan Study, which is a large, prospective cohort study, and began in 2006 years. Cumulative METS‐VF was calculated by data from 2006 survey to 2010 survey and defined as the mean METS‐VF for each pair of consecutive surveys multiplied by the time intervals between these two consecutive surveys. The optimal cut‐off value for time‐averaged cumulative METS‐VF associated with CVD was determined using a survival‐time method to calculate maximally selected rank statistics and was used to assess exposure of high METS‐VF. A multivariate Cox proportional hazards regression model was used to assess the risk of CVD and all‐cause mortality during 2010–2022 years (hazard ratio [HR] and 95% confidence interval [95% CI]). Results: We included 41 756 participants (mean age, [52.72 ± 11.64] years, 78.53% males and 21.47% females). All participants were divided into four groups: Q1 (reference group), Q2, Q3 and Q4 according to the quartiles of cumulative METS‐VF, and exposure duration of high METS‐VF was quantified as 0, 2, 4, and 6 years. During the median follow‐up of 12.01 years, 4008 (9.60%) CVD events and 3944 all‐cause mortality events occurred. After adjusting for potential covariates, compared to participants in Q1 group, the HRs of incident CVD and all‐cause mortality were 1.55 (95% CI, 1.38–1.74) and 1.59 (95% CI, 1.40–1.81) for those in Q2 group, 2.13 (95% CI, 1.91–2.38) and 2.67 (95% CI 2.37–3.01) for those in Q3 group, 2.78 (95% CI, 2.49–3.17) and 4.90 (95% CI 4.36–5.50) for those in Q4 group. The HRs for CVD and all‐cause mortality were increased with exposure duration of high METS‐VF increasing. The result of ROC curve analysis showed that cumulative METS‐VF had the highest predictive for CVD among 4 indexes including cumulative METS‐VF, cumulative waist circumference, cumulative body mass index and cumulative WHtR. Conclusions: The high cumulative METS‐VF was associated with an increased risk of CVD and mortality, and this association was stronger as exposure to high METS‐VF was prolonged, emphasizing the importance of striving to control the METS‐VF.

Objective: We aimed to examine the association of triglyceride-glucose index (TyG) with risk for cardiovascular disease (CVD) among postmenopausal women. Methods: A total of 7741 participants met the inclusion criteria, and were included in the analysis. The TyG index was calculated as ln (triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2). The participants were classified into four groups by the quartiles of TyG index, and the Q1 group was used as the reference group. The cumulative incidence of CVD for the groups were compared using the Kaplan–Meier curves. The association between the TyG index and risk of CVD among postmenopausal women was assessed by the Cox proportional hazards models (hazard ratio [HR], 95% confidence intervals [CI]). Results: During a median follow-up of 12 years, a total of 383 (4.95%) participants developed incident CVD. After adjusting for potential confounding factors, a high baseline TyG index (Q4 group) was associated with higher future risk of CVD, the HR (95% CI) of CVD risk was 1.70 (1.21–2.38) in Q4 group compared with the Q1 group. Subgroup analyses showed the Q4 group was significantly associated with the risk of CVD, regardless of age at menopause (younger than 50 years; 50 years and older) and obesity status. Conclusions: Higher TyG index at baseline as a marker of insulin resistance (IR), is associated with higher risk of future CVD among postmenopausal women. The TyG index may serve as a simple and easy marker for early identification of high-risk individuals in the postmenopausal women.

Ideal cardiovascular health (CVH) is associated with reduced risk of cardiac and cerebral events. Arterial stiffness plays an important role in the progress of cardiac and cerebral events, but it is unclear whether ideal CVH, in particular, cumulative exposure to ideal CVH (cumCVH), is associated with reduced risk of arterial stiffness. We examined the association between cumCVH and arterial stiffness using data from the Kailuan Study. The study cohort consisted of 20,355 participants from the Kailuan community-based cohort, whose mean follow-up period was 3.36 years since baseline (visit 3). CumCVH was calculated as the summed average ideal CVH score between two consecutive visits, multiplied by the time between the two consecutive visits in years. Multivariable linear regression model analysis was used to evaluate the relationship between cumCVH and brachial ankle pulse wave velocity (baPWV).Variance inflation factor (VIF) was calculated to diagnose co-linearity between multiple variables. We also used logistic regression to evaluate the association between cumCVH and arterial stiffness by calculating the crude odds ratio (OR) and adjusted OR, with 95% confidence interval (CI). Sensitivity analysis was performed to test the robustness of our findings. The participants were classified into 5 groups according to the quintile of cumCVH exposure levels. Multivariate linear regression analysis showed that cumCVH had a significant inverse linear relationship with baPWV (B = -3.35, p < 0.001). The result of logistic regression demonstrated that compared with Q1 group,Q3, Q4, Q5 were associated with a 15%, 24%, 36% significantly lower incidence of arterial stiffness, after adjusting for confounders.What is more, the results of sensitivity analysis had no influence on our results. Exposure to higher cumCVH can prevent the increase in baPWV and reduce the incidence of arterial stiffness.

Background: The triglyceride–glucose index (TyG index), an alternative indicator of peripheral insulin resistance (IR), is associated with cardiovascular disease (CVD) in the general population. The aim of this research was to determine the correlation between early-onset stroke and the TyG index among young Chinese adults. Methods: Participants (age ≤ 40 years) who attended their first physical examination in Kailuan General Hospital or its 11 subsidiary hospitals between 2006 and 2012 were enrolled. The subjects were divided into four equal points according to the quartile of the TyG index, with the lowest quartile (Q1) as the reference group. A Cox proportional hazard model was employed to assess the correlation between early-onset stroke incidence and the TyG index. Restricted cubic spline analysis was further conducted to examine nonlinear associations. The TyG index was calculated as Ln [Triglyceride (TG, mg/dL) × Fasting Blood Glucose (FBG, mg/dL)/2]. Results: Overall, 35,999 subjects met the inclusion criteria. Their mean age was 30.8 ± 5.7 years, and 77.1% of subjects were males. During a median observation period of 11 years, 281 stroke events occurred (62 hemorrhagic strokes and 219 ischemic strokes). Compared to the Q1 group (as the lowest group), subjects in groups Q2-Q4 had significantly higher risks of early-onset stroke (P < 0.05) after adjustment for relevant confounders in the Cox proportional hazards model. Similar results were consistent with ischemic stroke. However, no significant associations were observed between the risk of hemorrhage and the baseline TyG index. The restricted cubic splines revealed that the risk of stroke progressively increased with a high TyG index ≥ 8.41. Conclusions: The TyG index may be a major risk factor for early-onset stroke among young Chinese adults. A TyG index ≥ 8.41 can be used as an indicator for screening high-risk stroke groups.