Association of cumulative obesity- and insulin resistance-related indices with incident cardiovascular disease in Chinese middle-aged and elderly populations: a nationwide prospective cohort study.

Researchers in China studied how obesity and insulin resistance affect heart disease and stroke risk in over 2,000 middle-aged and older adults. Rather than looking at single measurements, they tracked multiple body measurements over several years to understand cumulative effects. They examined 18 different markers related to body weight, fat distribution, and blood sugar control from 2012 to 2015, then followed participants until 2020 to see who developed cardiovascular disease. The study found that eight markers were strongly linked to heart disease and stroke risk. The most powerful predictor was something called estimated glucose disposal rate (eGDR), which measures how well your body uses insulin. Lower eGDR scores indicated higher heart disease risk. Other important markers included waist-to-height ratio, body roundness index, and several measures combining triglycerides with waist size or blood sugar levels. Interestingly, these associations were stronger in men than women. Nearly 18% of participants developed heart disease or had a stroke during the study period. For patients considering acupuncture, this research highlights the importance of addressing metabolic health as part of cardiovascular disease prevention. Traditional Chinese medicine, including acupuncture, has long recognized the interconnection between metabolic function, body composition, and heart health. Acupuncture may support metabolic balance and weight management as part of a comprehensive approach to reducing cardiovascular risk, particularly when combined with lifestyle modifications. To explore acupuncture for metabolic and cardiovascular health support, consult a licensed acupuncturist who is certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

This prospective cohort study from the China Health and Retirement Longitudinal Study (CHARLS) examined associations between 18 cumulative obesity and insulin resistance indices and incident cardiovascular disease in 2,124 middle-aged and elderly Chinese adults. Cumulative values were calculated as time-weighted averages from 2012-2015, with CVD outcomes (heart disease and stroke) assessed through 2020. Of participants, 17.80% (n=378) developed CVD. After full covariate adjustment, eight indices showed significant associations. Cumulative estimated glucose disposal rate (eGDR) demonstrated inverse association (HR per SD=0.683, 95% CI: 0.579-0.806) and highest predictive accuracy (AUC=0.617), followed by Chinese visceral adiposity index (CVAI, AUC=0.602). Seven indices showed positive associations including WHtR, BRI, TyG, TyG-WC, TyG-WHtR, and LAP (all HRs>1.10, P<0.05). Adding eGDR to traditional risk models improved discrimination (AUC: 0.628→0.654; NRI=0.285; IDI=0.016). Sex-stratified analyses revealed stronger associations in males for eGDR and CVAI. Clinical implications suggest cumulative metabolic markers, particularly eGDR and CVAI, may enhance CVD risk stratification in East Asian populations.