The highest tertile of the combined triglyceride-glucose and atherogenic index of plasma significantly increased the risk of incident cardiovascular diseases by 25% compared to the lowest tertile.
Cohort (n=6,986)
Yes
Does a higher TyG-AIP index predict the incidence of cardiovascular diseases in middle-aged and older adults?
Both baseline elevations and longitudinal increases in the TyG-AIP index are independently associated with a higher risk of developing cardiovascular diseases, particularly stroke, in middle-aged and older Chinese adults.
Effect estimate: HR 1.25 (95% CI 1.10-1.41)
Absolute Event Rate: 28.21% vs 21.25%
p-value: p=<0.001
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of death worldwide. The atherogenic index of plasma (AIP) reflects atherogenic dyslipidemia and triglyceride-glucose (TyG) index is a surrogate of insulin resistance (IR). Evidence on their combined value for CVDs risk stratification remain limited. In this study, the associations between baseline levels and longitudinal changes of the composite TyG-AIP index and the incidence of CVDs were evaluated among middle-aged and older adults. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). A total of 6,986 participants were included in the baseline analysis(2012-2020), and 4,134 participants with repeated biomarker measurements in 2012 and 2015 were included in the longitudinal trajectory analysis. Multivariable cox proportional hazards models and restricted cubic spline(RCS) were applied to evaluate the associations of TyG, AIP, TyG 0.631 for stroke; 0.605 for heart disease). NRI and IDI analyses demonstrated that adding TyG-AIP significantly improved risk reclassification for CVDs (NRI, 0.036-0.054, P < 0.001) and stroke (NRI, 0.096-0.114, P < 0.001). In longitudinal analyses (N = 4,134), participants in the cluster with persistently high and rising TyG-AIP values exhibited the highest risks of CVDs (adjusted HR 1.25, 95% CI: 1.04-1.51), stroke (HR 1.43, 95% CI: 1.05-1.95), and heart disease (HR 1.25, 95% CI: 1.01-1.54). CONCLUSION: Both baseline and longitudinal changes of TyG-AIP were independently associated with the risk of developing CVDs, especially stroke, in middle-aged and older Chinese adults. Repeated assessment of TyG-AIP captured cardiometabolic deterioration over time and improved identification of individuals at elevated cardiovascular risk. Incorporating long-term monitoring of TyG-AIP into routine health evaluations may enhance population-level CVDs risk prediction and support more effective prevention strategies.
Chen et al. (2025) conducted a cohort in Cardiovascular diseases (n=6,986). High TyG-AIP index (Tertile 3) vs. Low TyG-AIP index (Tertile 1) was evaluated on Incidence of cardiovascular diseases (HR 1.25, 95% CI 1.10-1.41, p=<0.001). The highest tertile of the combined triglyceride-glucose and atherogenic index of plasma significantly increased the risk of incident cardiovascular diseases by 25% compared to the lowest tertile.