Cardiovasc Diabetol Endocrinol Rep. 2026 Jul 29;12(1):49. doi: 10.1186/s40842-026-00315-2.
ABSTRACT
BACKGROUND: The cholesterol, high-density lipoprotein, and glucose (CHG) index has been linked to stroke risk. However, evidence is largely based on single-time-point measurements and has not been compared with cumulative exposure, nor evaluated in individuals with cardiovascular-kidney-metabolic syndrome (CKM) stages 0-3. This study aimed to compare the associations of baseline and cumulative CHG index with incident stroke risk in this population.
METHODS: Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). The exposure measures were the baseline and cumulative levels of the CHG index. Multivariable logistic regression models were employed to examine the association between the baseline and cumulative CHG index and stroke risk. Restricted cubic spline (RCS) analysis was used to test potential dose-response relationships. The receiver operating characteristic (ROC) curve was used to compare the predictive performance of the two measures. Subgroup analyses were conducted to evaluate the consistency of these associations in different populations.
RESULTS: Among 4,661 participants with CKM stages 0-3, 476 (10.2%) developed incident stroke during follow-up. After adjustment for demographic characteristics, lifestyle factors, anthropometric measurement, laboratory parameters, medication use and comorbidities, both the baseline CHG index (OR = 1.42, 95% CI: 1.12-1.81) and cumulative CHG index (OR = 1.14, 95% CI: 1.03-1.26) were positively associated with stroke risk. Participants in the highest tertile (T3) of the baseline CHG index had a 35% higher stroke risk than those in the lowest tertile (T1) (OR = 1.35, 95% CI: 1.03-1.76), and a 34% elevated risk was observed for the cumulative CHG index (OR = 1.34, 95% CI: 1.03-1.76). RCS analysis revealed linear relationships for both measures (p for non-linear = 0.331 and 0.817, respectively; overall p < 0.05 for both). ROC curve analysis showed no statistically significant difference in the area under the curve (AUC) between the two measures (0.672 vs. 0.671, p = 0.330). Subgroup analyses indicated that the associations might be modified by gender and drinking status.
CONCLUSIONS: Among individuals with CKM stages 0-3, both baseline and cumulative CHG indices were independently associated with incident stroke risk. Given its moderate discriminatory capacity, the CHG index-derived from routine blood tests-may serve as a preliminary screening tool to flag high-risk individuals, prompting more comprehensive stroke risk evaluation.
PMID:42522042 | DOI:10.1186/s40842-026-00315-2
