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April 27, 2026Cardiovascular Diabetology3 citationsOpen Access

Comprehensive evaluation of the triglyceride glucose index (TyG) and body roundness index (BRI) on cardiovascular disease risk prediction: a 9-year prospective cohort study in Chinese middle-aged and older adults

MGMengyao GuHHHaofei HuDGDayong Gu

Key Result

The composite index TyG+BRI was associated with the highest risk of incident cardiovascular disease (HR 1.773) in Chinese middle-aged and older adults.

Key Points

  • This study aims to evaluate how the body roundness index (BRI) mediates the relationship between the triglyceride glucose index (TyG) and cardiovascular disease (CVD) risk.
  • Conducted a 9-year prospective cohort study in Chinese middle-aged and older adults.
  • Analyzed baseline and follow-up measurements of BRI and TyG with respect to CVD risk.
  • Explored the interaction between metabolic risk factors and their influence on CVD development.
  • Higher baseline and follow-up BRI were associated with increased CVD risk.
  • The study suggests that BRI significantly mediates the relationship between TyG and CVD risk.
  • Indicates the importance of addressing body composition and metabolic health in high-risk populations.

Study Design

Type

Cohort (n=7,853)

Multicenter

Yes

Structured PICO

Do elevated triglyceride glucose index (TyG) and body roundness index (BRI) increase the risk of incident cardiovascular disease in Chinese middle-aged and older adults?

P
Population
7,853 Chinese middle-aged and older adults (age ≥40) without pre-existing cardiovascular disease (coronary heart disease or stroke) at baseline, drawn from the nationwide CHARLS prospective study.
I
Intervention
Elevated triglyceride glucose index (TyG), body roundness index (BRI), and their composite formulations ('TyG&BRI group', 'TyG-BRI', and 'TyG+BRI').
C
Comparator
Lower levels of TyG, BRI, and their composite indexes (e.g., TyG < median and BRI < median).
O
Outcome
Incident cardiovascular disease (defined as participant-reported coronary heart disease or cerebrovascular incidents/stroke) over a 9-year follow-up.hard clinical

The combination of triglyceride glucose index and body roundness index significantly predicts incident cardiovascular disease risk, highlighting the interplay between insulin resistance and visceral adiposity.

Main Result

Effect estimate: HR 1.773 (95% CI 1.499-2.097)

Limitations

  • Reliance on self-reported cardiovascular disease outcomes without systematic medical confirmation.

Abstract

In conclusion, our study highlights the critical role of BRI as a mediator in the relationship between TyG and CVD risk. The findings indicate that both baseline and follow-up BRI significantly contribute to the pathway linking TyG to CVD, suggesting that individuals with higher BRI are at an increased risk. The antagonistic interaction underscores the complexity of metabolic risk factors in CVD development and emphasizes the need for a multifaceted approach in risk assessment and management. Future research should focus on elucidating the biological mechanisms underlying this interaction and exploring potential interventions that target body composition and metabolic health to mitigate CVD risk in high-risk populations.

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Cite This Study

Gu et al. (2026) conducted a cohort in Cardiovascular disease risk (n=7,853). Composite index TyG+BRI vs. Lower levels or individual indexes was evaluated on Incident cardiovascular disease (coronary heart disease or stroke) (HR 1.773, 95% CI 1.499-2.097). The composite index TyG+BRI was associated with the highest risk of incident cardiovascular disease (HR 1.773) in Chinese middle-aged and older adults.

synapsesocial.com/papers/69eefcf4fede9185760d3ae4https://doi.org/10.1186/s12933-026-03092-5
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association between changes in the triglyceride glucose-body roundness Index and cardiovascular disease risk in middle-aged and elderly Chinese adults: a nationwide longitudinal study from 2011 to 20152025 · 9 citations
  2. 2Combined association of the triglyceride glucose index and body roundness index with cardiovascular disease in middle-aged and elderly persons with diabetes: a CHARLS-based cohort study2026
  3. 3Association between triglyceride glucose-body roundness index and incidence diabetes mellitus: a cohort study2026
  4. 4Association of body roundness index with cardiovascular disease in early Cardiovascular-Kidney-Metabolic syndrome stage 0–3: mediation by the triglyceride-glucose index in a national cohort study2025
  5. 5Association of the triglyceride glucose–body roundness index with mortality in HFpEF and effect modification by nutritional status: a multicenter prospective cohort study2025