Association of combined TyG-BMI and hs-CRP with incident cardiovascular disease in an aging Chinese population: A nationwide prospective cohort study

BACKGROUND: Cardiovascular diseases (CVD) are a leading cause of global mortality and disability, with insulin resistance and inflammation indicated by high-sensitivity C-reactive protein (hs-CRP) as key risk factors. METHODS: Data from 9190 participants in a nationwide health and retirement longitudinal study were analyzed. Participants with missing data or a history of stroke or heart disease at baseline were excluded. Baseline TyG-BMI and hs-CRP were measured. CVD events (based on self-reported physician diagnoses) were assessed using standardized surveys. Cox proportional hazards models were applied to evaluate the association of combined TyG-BMI and hs-CRP levels with incident CVD, adjusting for covariates. The reference group comprised participants with TyG-BMI below the median and hs-CRP <1 mg/L. RESULTS: The presence of elevated TyG-BMI and hs-CRP levels was significantly associated with an increased risk of CVD, with an adjusted hazard ratio (aHR) of 1.215 (95% CI 1.085-1.362). The risk was particularly pronounced in the age group of 45-59 years, with an aHR of 1.325 (95% CI 1.131-1.552) for cardiovascular diseases and 1.687 (95% CI 1.143-2.490) for stroke in the 60-69 years age group. The study also indicated a nonlinear correlation between TyG-BMI and incident CVD, and a linear correlation for hs-CRP. CONCLUSION: The combined elevation of baseline TyG-BMI and hs-CRP is associated with higher incident CVD risk in an aging Chinese population, with the strongest associations observed for CVD in adults aged 45-59 years and for stroke in those aged 60-69 years. These findings suggest that integrating both markers into clinical risk assessment may help refine cardiovascular risk stratification, pending further validation in independent cohorts.