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<p>This study aimed to examine the association between the CHG (cholesterol, high-density lipoprotein, and glucose) index and future type 2 diabetes mellitus (T2DM) risk in Chinese adults with prediabetes. We conducted a retrospective cohort study of 14,192 adults with prediabetes, identified from 2010 to 2016 health examination records. Multivariable Cox models were used to assess associations, with restricted cubic splines exploring nonlinearity. During a mean 3.0‑year follow‑up, 1,748 participants (12.3%) developed diabetes. A nonlinear association was observed, with an inflection point at CHG = 5.22. Above this threshold, higher CHG levels were associated with a significantly lower diabetes risk (HR 0.55, 95% CI 0.40–0.75). Subgroup analysis revealed a significant interaction with sex: higher CHG correlated with reduced risk in men but increased risk in women. In conclusion, the CHG index demonstrates a nonlinear, threshold-dependent association with T2DM risk that differs substantially by sex among Chinese prediabetic adults. This composite marker may help refine risk stratification, though sex-specific interpretation is essential. Prospective studies are needed to validate its predictive utility and elucidate underlying mechanisms.</p>

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Nonlinear associations between the cholesterol, high-density lipoprotein, and glucose index and type 2 diabetes risk in Chinese prediabetic adults: a cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月4日

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  • Yuwei Xing,
  • Yishan Yin,
  • Qianqian Zhao

摘要

This study aimed to examine the association between the CHG (cholesterol, high-density lipoprotein, and glucose) index and future type 2 diabetes mellitus (T2DM) risk in Chinese adults with prediabetes. We conducted a retrospective cohort study of 14,192 adults with prediabetes, identified from 2010 to 2016 health examination records. Multivariable Cox models were used to assess associations, with restricted cubic splines exploring nonlinearity. During a mean 3.0‑year follow‑up, 1,748 participants (12.3%) developed diabetes. A nonlinear association was observed, with an inflection point at CHG = 5.22. Above this threshold, higher CHG levels were associated with a significantly lower diabetes risk (HR 0.55, 95% CI 0.40–0.75). Subgroup analysis revealed a significant interaction with sex: higher CHG correlated with reduced risk in men but increased risk in women. In conclusion, the CHG index demonstrates a nonlinear, threshold-dependent association with T2DM risk that differs substantially by sex among Chinese prediabetic adults. This composite marker may help refine risk stratification, though sex-specific interpretation is essential. Prospective studies are needed to validate its predictive utility and elucidate underlying mechanisms.