The Association Between Cholesterol, High-Density Lipoprotein, and Glucose Index and Mortality in Young and Middle-Aged Adults With Diabetes or Prediabetes: NHANES Data (1999–2018)

Background: This study aimed to investigate the association between cholesterol, high-density lipoprotein, and glucose (CHG) index and mortality among patients with diabetes or prediabetes and to determine whether this association changes with age. Methods: From the National Health and Nutrition Examination Survey (1999–2018), 14,369 patients with diabetes or prediabetes were selected and divided into two age groups: 50 years and younger, and older than 50 years. The Cox proportional hazards models, restricted cubic spline (RCS) models and interaction test were employed to analyze the associations between CHG index and mortality. Results: During a median follow-up of 96 months, 2,741 deaths from all causes and 899 deaths related to cardiovascular issues were recorded. Cox proportional hazards regression analysis found a positive correlation between the CHG index and mortality from all causes, as well as cardiovascular causes. According to the RCS model, there is a U-shaped correlation between the baseline CHG index and mortality, and age significantly interacts with this relationship. The study revealed a significant correlation between increased CHG and a heightened risk of death in people aged 50 years and below. Conclusions: We found that the CHG index is associated with mortality in individuals younger than 50 years, underscoring the critical role of the CHG index in identifying and screening for mortality risk among those with early-onset diabetes.