Associations of cumulative exposure and dynamic trajectories of cholesterol-HDL-glucose (CHG) index with cardiovascular disease in middle-aged and older Chinese adults: a longitudinal analysis

作者：Yuting Zhang, Bei Liu, Yuan Zhu, Yao-Fei Xie, Yan-Ling Du, Peng Xiong, Qi-yuan Lyu · 发表于：Cardiovascular Diabetology · 年份：2026 · DOI：10.1186/s12933-026-03137-9 · 被引用次数：10 · 研究领域：Medicine

Background A newer and novel index, the Cholesterol, High-Density Lipoprotein, and Glucose (CHG) index, has been proposed as a potential index for metabolic disorders. However, research on the relationship between CHG changes and cardiovascular disease (CVD) is limited. Our research aims to investigate the association between cumulative exposure and dynamic trajectories of CHG and cardiovascular disease risk. Methods Participants aged 45 and older were recruited from the China Health and Retirement Longitudinal Study (CHARLS). CVD was defined as self-reported description. K-means clustering analysis was used to classify dynamic CHG changes, and cumulative CHG (cuCHG) was calculated as follows: cuCHG=(CHG2012 + CHG2015)/time interval (2012–2015). Cox proportional hazards regression and restricted cubic spline (RCS) regression models were conducted to evaluate the association between cumulative exposure and dynamic trajectories of CHG and CVD risk. Results A total of 6,171 participants were included in the study, among whom 1,136 (18.4%) experienced incident of CVD. The risk of CVD increased with higher levels of cuCHG. K-means clustering indicated three distinct trajectories CHG variation. Compared to the stable reference group (Cluster 3), participants in the high-risk slowly increasing trajectory (Cluster 2) had a significantly higher risk of CVD (HR = 1.28, 95%CI: 1.10–1.49, P = 0.002). However, the moderate-decreasing trajectory (Cluster 1) was not significantly associated...