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Objective <p>Cholesterol, High-density lipoprotein, and Glucose (CHG) index has recently been proposed as a marker of metabolic dysfunction. However, the association of CHG and CHG modified indices with the risk of stroke remains unclear.</p> Methods <p>We analyzed 8908 participants aged 45 years or older from the CHARLS. Baseline CHG and its modified forms (CHG-WC, CHG-BMI, CHG-BRI, CHG-WWI, CHG-WHtR, CHG-ABSI, and CHG-CVAI) were collected. Kaplan–Meier curves, Cox proportional hazards models, and restricted cubic spline (RCS) analyses were applied to assess associations with incident stroke.</p> Results <p>During a 9-year follow-up period, 828 (9.3%) participants had occurred strokes. Our analysis found a significant positive association between CHG, CHG-WC, CHG-BMI, CHG-BRI, CHG-WWI, CHG-WHtR, CHG-ABSI, CHG-CVAI, with stroke risk. The adjusted HR for the highest quartile compared to the lowest were: CHG 1.57 (95% CI:1.18–2.10), CHG-WC 1.72 (95% CI:1.34–2.20), CHG-BMI 1.62 (95% CI:1.26–2.08), CHG-BRI 1.65 (95% CI:1.29–2.10), CHG-WWI 1.71 (95% CI:1.32–2.23), CHG-WHtR 1.67 (95% CI:1.29–2.16), CHG-ABSI 1.41 (95% CI:1.10–1.80), and CHG-CVAI 1.99 (95% CI:1.54–2.57), with CHG-CVAI showing strongest associations. The RCS revealed a significant linear association between CHG, CHG-WC, CHG-BMI, and CHG-CVAI with the risk of stroke, whereas CHG-BRI, CHG-WWI, CHG-WHtR, and CHG-ABSI showed significant nonlinear associations with stroke risk. According to ROC analysis, CHG-CVAI had the highest predictive power for stroke risk (C-index:0.618).</p> Conclusions <p>Elevated CHG and its modified indices were strongly associated with stroke risk in middle-aged and older Chinese populations. CHG-related indices combined with obesity measures may help enhance the identification of individuals at higher risk of stroke.</p>

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Association of cholesterol, high-density lipoprotein, and glucose index and its modified indices with the risk of stroke: insights from CHARLS

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  • 发表日期：

    2025年12月18日

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  • Yuqi Zeng,
  • Dayong Zhou,
  • Yan Chen,
  • Guijun Huo

摘要

Objective

Cholesterol, High-density lipoprotein, and Glucose (CHG) index has recently been proposed as a marker of metabolic dysfunction. However, the association of CHG and CHG modified indices with the risk of stroke remains unclear.

Methods

We analyzed 8908 participants aged 45 years or older from the CHARLS. Baseline CHG and its modified forms (CHG-WC, CHG-BMI, CHG-BRI, CHG-WWI, CHG-WHtR, CHG-ABSI, and CHG-CVAI) were collected. Kaplan–Meier curves, Cox proportional hazards models, and restricted cubic spline (RCS) analyses were applied to assess associations with incident stroke.

Results

During a 9-year follow-up period, 828 (9.3%) participants had occurred strokes. Our analysis found a significant positive association between CHG, CHG-WC, CHG-BMI, CHG-BRI, CHG-WWI, CHG-WHtR, CHG-ABSI, CHG-CVAI, with stroke risk. The adjusted HR for the highest quartile compared to the lowest were: CHG 1.57 (95% CI:1.18–2.10), CHG-WC 1.72 (95% CI:1.34–2.20), CHG-BMI 1.62 (95% CI:1.26–2.08), CHG-BRI 1.65 (95% CI:1.29–2.10), CHG-WWI 1.71 (95% CI:1.32–2.23), CHG-WHtR 1.67 (95% CI:1.29–2.16), CHG-ABSI 1.41 (95% CI:1.10–1.80), and CHG-CVAI 1.99 (95% CI:1.54–2.57), with CHG-CVAI showing strongest associations. The RCS revealed a significant linear association between CHG, CHG-WC, CHG-BMI, and CHG-CVAI with the risk of stroke, whereas CHG-BRI, CHG-WWI, CHG-WHtR, and CHG-ABSI showed significant nonlinear associations with stroke risk. According to ROC analysis, CHG-CVAI had the highest predictive power for stroke risk (C-index:0.618).

Conclusions

Elevated CHG and its modified indices were strongly associated with stroke risk in middle-aged and older Chinese populations. CHG-related indices combined with obesity measures may help enhance the identification of individuals at higher risk of stroke.