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Background The Cardiovascular-Kidney-Metabolic (CKM) syndrome integrates the pathophysiology of metabolic disease, chronic kidney disease, and cardiovascular disease. Accessible biomarkers for risk stratification are urgently needed, especially in high-risk populations like patients with type 2 diabetes (T2D). We compared the novel Triglyceride-Glucose-Chinese Visceral Adiposity Index (TyG-CVAI) against established insulin resistance (IR) surrogates for its association with CKM severity in T2D. Methods This cross-sectional study analyzed 5,609 adults with T2D from community health centers in Shenzhen, China (2023). CKM stages (2–4) were defined per AHA criteria. The associations of TyG, TyG-BMI, TyG-WHtR, and TyG-CVAI with CKM stage were assessed using Spearman correlation and multivariable ordinal logistic regression. Discriminatory performance for late-stage CKM (Stages 3–4) was evaluated using ROC curve analysis. Results TyG-CVAI showed the strongest correlation with CKM stage (ρ = 0.326, P 0.001). In fully adjusted models, a one-SD increase in TyG-CVAI was associated with higher odds of advanced CKM stage (OR = 1.20, 95% CI: 1.11–1.29, P 0.001). This association was consistent across sex and hypertension subgroups but stronger in participants aged ≥60 years ( P for interaction = 0.036). For discriminating late-stage CKM, TyG-CVAI achieved a significantly higher AUC (0.720, 95% CI: 0.705–0.734) than TyG (0.574), TyG-BMI (0.570), and TyG-WHtR (0.587) (all P 0.001). Conclusion In adults with T2D, TyG-CVAI demonstrates a superior association with CKM severity and better diagnostic accuracy for late-stage CKM compared to simpler TyG-based indices. It represents a promising, accessible biomarker for identifying higher CKM stage severity, with better discriminatory ability than simpler TyG-based indices, in this high-risk population.
Yang et al. (Fri,) studied this question.