Triglyceride-glucose index and its related factors may be predictors for cardiovascular disease among Chinese postmenopausal women: a 12-year cohort study

BACKGROUND: This study investigated and compared the abilities of the triglyceride glucose index (TyG) and its correlated factors involving TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), and TyG-waist circumference (TyG-WC) to predict cardiovascular disease (CVD) among Chinese postmenopausal women. This topic has not been adequately explored in the existing literature. METHODS: This prospective study included 1110 Chinese postmenopausal women, stratified into the CVD group and the non-CVD group. The TyG index and its correlated components (TyG, TyG-BMI, TyG-WHtR, and TyG-WC) were calculated. The primary endpoint was CVD. RESULTS: Across a 12-year follow-up period, 76 (6.84%) CVDs were documented. The TyG index, in collaboration with various indicators of obesity, demonstrated a robust positive correlation with the risk of CVD. In comparison to other TyG indices, TyG-WC was the strongest predictor for CVD (HR: 2.61, 95%CI:1.64-4.14; P < 0.001), and the TyG-WHtR index exhibited the strongest diagnostic value in identifying CVD (AUC: 0.632, 95%CI: 0.603-0.660; P < 0.001). Incorporating TyG-WHtR into the base model significantly enhanced incremental risk stratification for CVD (NRI: 0.115, 95%CI: 0.040-0.190, P < 0.05; AIC: 996; BIC: 1041; Harrell's C-index: 0.73). Decision curve analysis (DCA) suggested that TyG, TyG-WHtR, and TyG-WC can provide significant clinical benefits for Chinese postmenopausal women. The sensitivity analyses have demonstrated the robustness of these results. CONCLUSIONS: The TyG index and its correlated factors can effectively predict CVD in Chinese postmenopausal women. TyG-WHtR has the most potent ability to predict CVD among postmenopausal women.