Association of a novel index, the total cholesterol–high-density lipoprotein–glucose index, with diabetes mellitus in Chinese adults: a retrospective cohort study

Objective: Research on the relationship between Total Cholesterol, High-Density Lipoprotein, and Glucose (CHG) index and diabetes mellitus (DM) risk remains limited. This study aims to investigate the association between CHG and DM incidence. Methods: This retrospective cohort study included 8,844 participants who underwent comprehensive health examinations at Shenzhen Kuichong People's Hospital between 2018 and 2023. The maximum individual follow-up duration reached 5 years, with a median (interquartile range) follow-up period of 2.72 (2.58-4.78) years. Cox proportional hazards regression models were used to evaluate the association between CHG and DM risk. ROC analysis was conducted to evaluate the predictive capability of CHG for DM. Finally, subgroup analyses and sensitivity analyses were performed to further verify the stability of these findings. Results: After multivariate adjustment, the CHG index was independently associated with increased DM risk, with an HR of 1.150 (95% CI: 1.098-1.204) per 0.1 unit increase in CHG. Furthermore, ROC curve analysis demonstrated that CHG had the highest AUC (0.7377) for predicting DM risk, compared to TC (0.5375), HDL-c (0.6105), and FPG (0.6761). The stability of these results was further validated through sensitivity and subgroup analyses. Conclusion: This study found an independent positive relationship between CHG and DM risk. Additionally, CHG demonstrates a certain predictive value for DM risk. This helps clinicians identify high-risk individuals for DM early and provides a new perspective for optimizing clinical prevention and management of DM.