The relationship between longitudinal changes in triglyceride-glucose-body mass index and new-onset diabetes in middle-aged and elderly adults: Evidence from a nationwide Chinese cohort study

Abstract

Objective

This study investigates the association between changes in TyG-BMI and the risk of diabetes mellitus (DM) in middle-aged and elderly adults in China, as prior research has mainly focused on single baseline measurements.

Methods

Data were obtained from CHARLS, a nationwide prospective cohort study. TyG-BMI changes (2011–2015) were analyzed using K-means clustering. Cox proportional hazards regression models assessed the relationship between TyG-BMI changes, cumulative TyG-BMI, and DM risk, with sensitivity and subgroup analyses ensuring robustness.

Results

Compared to individuals with consistently low TyG-BMI (class 1), hazard ratios (HRs) for DM were 1.474, 2.250, and 3.142 for participants with moderately sustained and slowly increasing TyG-BMI (class 2), slowly increasing high level of TyG-BMI (class 3), and the highest and increasing TyG-BMI levels (class 4), respectively. △TyG-BMI_2015-2011 (per 10-unit) yielded HRs of 1.064 for class 2, 1.108 for class 3, and 1.079 for class 4. Cumulative TyG-BMI (per 10-unit) had an HR of 1.029.

Conclusion

TyG-BMI changes and sustained exposure to high TyG-BMI levels are independently linked to increased DM risk. Monitoring long-term fluctuations in TyG-BMI could be an important strategy for preventing DM, and effectively controlling high TyG-BMI through various interventions may significantly reduce DM risk.