Association between changes of triglyceride glucose-Chinese visceral adiposity index and cardiovascular disease in Chinese adults aged 45 and above

Background To investigate whether baseline triglyceride glucose-Chinese visceral adiposity index (TyG-CVAI), changes in TyG-CVAI, and cumulative average TyG-CVAI were predictive of incident cardiovascular disease (CVD) among Chinese adults aged 45 and above. Methods Utilizing data from the Global Burden of Disease 2021 for China, we assessed trends in CVD and the contribution of risk factors in China. Within the China Health and Retirement Longitudinal Study, 6963 participants contributed to baseline TyG-CVAI analyses and 3298 to changes in TyG-CVAI analyses. We applied k-means clustering to categorize participants into three TyG-CVAI trajectory patterns based on the dynamic changes in TyG-CVAI measurements over time. To investigate the association between TyG-CVAI and CVD, we utilized Cox regression models with three levels of adjustment and conducted restricted cubic spline analyses. We evaluated robustness through subgroup and sensitivity analyses. Results From 1990 to 2021, disability-adjusted life years attributable to metabolic risks showed modest improvement with high low-density lipoprotein cholesterol (average annual percentage change (AAPC), − 0.38; 95% CI [− 0.51, − 0.24]) and high fasting blood glucose (AAPC, − 0.33; 95% CI [− 0.58, − 0.09]), and high body mass index (AAPC, 0.86; 95% CI [0.70, 1.02]). A higher baseline TyG-CVAI was linked to a raised risk of incident CVD (HR, 1.17; 95% CI [1.11, 1.24]). Cumulative average TyG-CVAI followed similar patterns. The higher risk was observed in individuals with stable high TyG-CVAI (HR, 1.45; 95% CI [1.16, 1.81]) and stable medium TyG-CVAI (HR, 1.22; 95% CI [1.01, 1.49]), compared to those with stable low TyG-CVAI. The robustness and predictive accuracy of TyG-CVAI for CVD were affirmed by subgroup and multiple sensitivity analyses. Conclusions Changes in TyG-CVAI and cumulative average TyG-CVAI are associated with varying risks of incident CVD in Chinese adults aged 45 and above. Participants with higher TyG-CVAI trajectory levels over time exhibited progressively greater risks of CVD.