Triglyceride-Glucose Index and 10-Year Atherosclerotic Cardiovascular Disease Risk: Associations of Obesity-Related Indices in Two Nationally Representative Populations

BACKGROUND: The triglyceride-glucose (TyG) index has been associated with atherosclerotic cardiovascular disease (ASCVD) risk. However, the associations of TyG-related indices combined with obesity measures, including body mass index, waist circumference (WC), waist-to-height ratio, and body roundness index, with 10-year ASCVD risk across different populations remain unclear. METHODS: = 13,527) were analyzed. Weighted multivariable logistic regression, restricted cubic spline (RCS) analyses, and subgroup analyses were performed to evaluate the associations between TyG-related indices and 10-year ASCVD risk. RESULTS: TyG and TyG-related indices were significantly associated with higher 10-year ASCVD risk in both cohorts. Nonlinear associations were observed between several TyG-related indices and ASCVD risk. Compared with the U.S. population, obesity-related TyG composite indices showed relatively stronger associations with ASCVD risk among Chinese adults. Subgroup analyses demonstrated more pronounced associations among females in the CHARLS cohort, whereas in NHANES, significant sex differences were observed only for the TyG index. Among the evaluated indices, TyG-WC showed relatively stronger associations with ASCVD risk across both datasets. CONCLUSION: TyG-related indices were significantly associated with 10-year ASCVD risk across Chinese and U.S. populations, although the strength of these associations varied between populations. TyG-WC may provide additional value for ASCVD risk assessment. Further longitudinal studies are warranted to validate these findings and clarify the underlying mechanisms.