Predictive Value of the Triglyceride-Glucose-Frailty Index for Depression and Cognitive Function in Perimenopausal Women: Insights from CHARLS

Hengyu Chi,1,* Qunqi Hu,1,* Jingqi Liang,1,* Jingjing Zhang,1 Siying Qu,1 Hanzhi Wang,2 Yurong Kang,1 Zhouqi Liu,1 Yuran Chen,1 Yongliang Jiang,1 Xiaofen He,1 Jianqiao Fang,1 Yinhang Zhong31Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China; 2Department of Gynecology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People’s Republic of China; 3Department of Traditional Chinese Pharmacy, Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang, 311200, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yinhang Zhong, Department of Traditional Chinese Pharmacy, Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang, 311200, People’s Republic of China, Email [email protected] Jianqiao Fang, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China, Email [email protected]: Perimenopause represents a critical neuroendocrine transition stage in the lives of women, characterized by metabolic disorders and physiological vulnerability, which also commonly manifests as depression and cognitive impairment. This study explores associations between the triglyceride-glucose-frailty index (TyGFI) and depression/cognitive impairment in perimenopausal women.Methods: Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS) and 2,596 perimenopausal women were included. Logistic regression models were used to evaluate the association between TyGFI and depression/cognitive impairment. Restricted cubic spline (RCS) curves were plotted to visualize the dose–response relationship. Subgroup analyses and receiver operating characteristic (ROC) curves were used to assess interaction effects and evaluate the discriminatory ability of TyGFI. The results were expressed as odds ratios (OR) with 95% confidence intervals (CI).Results: Perimenopausal women with higher TyGFI levels exhibited a greater tendency towards depression and cognitive impairment, older age, higher blood pressure, and poorer self-reported health. In the fully adjusted model, each one-point increase in TyGFI was associated with elevated risk of depression (OR = 3.70, 95% CI: 3.18– 4.32) and cognitive impairment (OR = 1.51, 95% CI: 1.34– 1.71). RCS curves confirmed non-linear, positive associations and clear dose–response trends. Subgroup analysis revealed that the associations remained largely robust across most subgroups. ROC analysis demonstrated moderate-to-good discriminatory ability, with area under the curve (AUC) of 0.786 for depression and 0.634 for cognitive impairment.Conclusion: The TyGFI was concurrently correlated with depression and cognitive impairment in Chinese perimenopausal women, which may serve as a potential indicator for clinical risk screening.Keywords: perimenopause, triglyceride-glucose index, frailty index, depression, cognitive impairment, CHARLS