Abstract
Background
Despite notable progress in early detection and treatment over recent decades, cardiovascular disease (CVD) remains the leading cause of mortality in Lithuania. According to data from the Health Information Centre of the Institute of Hygiene, diseases of the circulatory system accounted for more than half (50.8%) of all deaths in 2025. As research increasingly turning toward metabolic biomarkers to enhance early identification of individuals at elevated CVD risk. This study aimed to investigate the prognostic value of the triglyceride–glucose and body mass index (TyG-BMI) for predicting the first event of CVD in Lithuanian adults.
Methods
Data were drawn from the Health, Alcohol, and Psychosocial Factors in Eastern Europe (HAPIEE) cohort, conducted in Kaunas between 2006 and 2008. The analytic sample comprised 5,532 participants aged 45-72 years without CVD at the baseline. The incident CVD events were recorded over a mean follow-up period of 13.9 years (SD = 4.67). TyG-BMI values were calculated according to TyG index = ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) ÷ 2]; and TyG-BMI index = TyG × BMI. Associations between TyG-BMI indices and CVD incidence were examined using Cox proportional hazards models.
Results
Over the follow-up period, 1,239 individuals experienced a first CVD event, resulting in a new event rate of 22.4%. After adjusting for sex, age, education, marital status, self-rated health, cholesterol level, lifestyle habits, psychological well-being status, arterial hypertension, and diabetes mellitus, the results show that TyG BMI was associated with increased CVD risk: hazard ratio (HR) for a ten-unit increase of TyG-BMI index was 1.019 (95%CI:1.006-1.032; p = 0.005).
Conclusions
These findings demonstrate that TyG BMI is significantly associated with the risk of a first CVD event in adults aged 45-72 years. The results underscore the potential relevance of metabolic indices in refining CVD risk assessment strategies.
Key messages
• New metabolic biomarkers were evaluated to improve early identification of individuals at increased risk of CVD.
• TyG BMI is significantly associated with the risk of a first CVD event in adults aged 45-72 years.