Two-wave average/cumulative TyG-ABSI and incident cardiovascular disease in CKM syndrome: a CHARLS cohort study

Repeated TyG-ABSI measurements may capture longer-term metabolic and adiposity-related exposure, but their contribution beyond a baseline value remains uncertain. We examined associations of two-wave average/cumulative TyG-ABSI and two-time-point exposure-pattern categories with incident cardiovascular disease (CVD) among adults with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3 in the China Health and Retirement Longitudinal Study. TyG-ABSI was assessed at Wave 1 (2011–2012) and Wave 3 (2015), and CVD was ascertained at Wave 4 (2018). Logistic regression models adjusted for baseline age, sex, education, smoking, and drinking. Among 4755 participants without clinical CVD before Wave 3, 902 developed incident CVD by Wave 4. Compared with the consistently low category, adjusted odds ratios were 2.38 (95% CI 1.63–3.46) for high baseline with decline and 1.64 (1.38–1.94) for persistently low-to-moderate. The odds ratio for moderate-to-high with slight decline was 1.28 (1.04–1.57). Each SD increase in two-wave average/cumulative TyG-ABSI was associated with higher CVD odds (OR 1.19, 95% CI 1.10–1.29). Baseline TyG-ABSI was also associated with CVD (OR 1.10, 95% CI 1.02–1.19). Two-wave average/cumulative TyG-ABSI and exposure-pattern categories were associated with incident CVD. Whether repeated assessment improves risk stratification beyond a single measurement requires dedicated validation.