# Combined 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 study

**Authors:** Xinbiao Fan, Yongchun Liang, Jun Ge, Xitong Sun, Xiaofei Geng, Boyu Zhu, Yuxin Kang, Zheng Zhang, Junping Zhang

PMC · DOI: 10.3389/fnut.2025.1724178 · Frontiers in Nutrition · 2026-01-14

## TL;DR

This study shows that high triglyceride glucose and body roundness indices together increase cardiovascular disease risk in older adults with diabetes.

## Contribution

The study is the first to investigate the combined effect of TyG index and BRI on CVD risk in a diabetic population.

## Key findings

- Participants with both high TyG and BRI had a 123% increased CVD risk compared to those with low TyG and BRI.
- High BRI alone was associated with an 85% increased CVD risk.
- The combined assessment of TyG and BRI improved CVD risk prediction in diabetic individuals.

## Abstract

Insulin resistance and visceral obesity are key pathologic mechanisms of CVD. However, the combined effect of the triglyceride glucose (TyG) index and body roundness index (BRI) on CVD risk in the diabetic population has not been thoroughly investigated.

The cohort study used data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2018, involving 1,010 participants with diabetes. Participants were categorized according to the median TyG index and/or BRI. Cox proportional risk regression models were used to examine the individual and joint associations of the two metrics with CVD risk. The study further estimated additive and multiplicative interaction effects.

During a median follow-up of 7 years, 251 participants developed CVD. The study confirmed a significant joint association between TyG index and BRI and the development of CVD in middle-aged and elderly persons with diabetes. Specifically, after adjusting for confounders, participants with both high TyG index and high BRI had a 123% increased risk of CVD compared with participants with both low TyG index and low BRI, and 85% for high BRI alone. In addition, the study did not find an additive and multiplicative interaction between BRI and TyG index on CVD.

This study found that high TyG index and high BRI were significantly associated with increased risk of new-onset CVD in a Chinese middle-aged and elderly diabetic population, and the combined assessment of the TyG index and BRI enhanced the prediction of CVD.

Flowchart illustrating a study on the combined association of TyG index and body roundness index (BRI) with cardiovascular disease (CVD) in diabetics. The methods section details the population (n=1010, with diabetes) studied from 2011 and exposed to TyG, BRI, and their combination over seven years. It reports 251 CVD cases. The results show a non-linear relationship between these indices and CVD risk. A table displays the combined association's statistical models, emphasizing significant correlations. The conclusion asserts that high TyG and BRI are linked to increased CVD risk, improving prediction in the studied population.

## Linked entities

- **Diseases:** diabetes (MONDO:0005015), cardiovascular disease (MONDO:0004995)
- **Species:** Homo sapiens (taxon 9606)

## Full-text entities

- **Diseases:** diabetes (MESH:D003920), Insulin resistance (MESH:D007333), cardiovascular disease (MESH:D002318), visceral obesity (MESH:D056128)
- **Chemicals:** TyG (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12846984/full.md

## References

36 references — full list in the complete paper: https://tomesphere.com/paper/PMC12846984/full.md

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Source: https://tomesphere.com/paper/PMC12846984