Routine metabolic–adiposity indices and incident cardiometabolic multimorbidity among adults with CKM stages 0–3: a prospective cohort study

作者：Zhenyu Geng, Yawei Rong, Jiahao Liu, Haochen Yang, Yulun Wang, Xunlu Yin, Xiangning He, Qian Chen, Fangfang Zhao, Guojun Wang · 发表于：BMC Cardiovascular Disorders · 年份：2026 · DOI：10.1186/s12872-026-06385-5 · 研究领域：Chronic Disease Management Strategies、Chronic Kidney Disease and Diabetes、Diabetes, Cardiovascular Risks, and Lipoproteins

Abstract Background Cardiometabolic multimorbidity (CMM) is an increasing burden in ageing populations. Cardiovascular-kidney-metabolic (CKM) stages 0–3 provide an upstream framework for identifying metabolic, renal, and cardiovascular vulnerability before overt multimorbidity. We evaluated whether routinely derived metabolic–adiposity indices add useful risk-phenotype information beyond established clinical factors. Methods This prospective CHARLS cohort included 7,062 adults aged ≥ 45 years who were free of CMM and had CKM stages 0–3 at baseline. Twenty-nine cholesterol–high-density lipoprotein cholesterol–glucose (CHG)-derived, triglyceride–glucose (TyG)-derived, and adiposity/body-shape indices were evaluated; the main text focused on RFM, CHG-RFM, TyG-RFM, BMI, and WC. Model 3 was used to anchor the primary association interpretation, while Model 4 was retained as an extended clinical-adjustment model to assess robustness after broader adjustment. Benjamini–Hochberg correction, inter-index correlations, paired CHG–TyG models, proportional-hazards diagnostics, prediction analyses, and sensitivity analyses were performed. Results Among 7,062 participants, 613 developed incident CMM (8.7%). In Model 3, the per-SD HRs (95% CIs) were 1.85 (1.52–2.25) for RFM, 1.72 (1.47–2.03) for CHG-RFM, 1.67 (1.41–1.98) for TyG-RFM, 1.30 (1.20–1.41) for BMI, and 1.34 (1.23–1.46) for WC. The corresponding estimates remained broadly consistent in Model 4. After Benjamini–Hochberg correction, ...