TyG and RC combined with CVD risk in CKM syndrome: A national cohort study

Although the triglyceride-glucose index (TyG, insulin resistance) and remnant cholesterol (RC, lipid metabolism) are cardiovascular disease (CVD) risk factors in cardiovascular-kidney-metabolic (CKM) syndrome, their joint predictive power warrants further investigation. We utilized data from the China Health and Retirement Longitudinal Study (2020). Using participants with low TyG (<8.3) and low RC (<13.9) as the reference, individuals with both high TyG and high RC showed significantly elevated CVD risk. Over a median follow-up of 9.0 years, 1744 participants (23.2%) in CKM Stages 0-3 developed CVD. Participants with both high TyG and high RC had the highest risk (HR = 1.35). The TyG-RC index was created by multiplying TyG and RC. Each 1-SD increase in TyG-RC was associated with higher CVD risk, exhibiting an inverse J-shaped relationship. Time-independent ROC analysis demonstrated TyG-RC has superior predictive value compared to TyG-BMI, TyG-WC, TyG-WHtR, eGDR and METSIR. For enhanced CVD risk assessment, the joint assessment TyG-RC index offers a more effective tool than using TyG or RC individually.