Supplementary file 1_Estimated glucose disposal rate shows the broadest associations with cardiometabolic multimorbidity progression in early cardiovascular–kidney–metabolic stages: a longitudinal cohort study.docx

Primary-model HRs per adverse standard deviation were 1.92 (95% confidence interval [CI], 1.77–2.09) for eGDR, 1.69 (95% CI, 1.57–1.82) for TyG, and 1.51 (95% CI, 1.39–1.64) for AIP. After CKM-stage adjustment, eGDR remained associated with all three disease-accumulation transitions (false-discovery-rate-adjusted P ≤ 0.009); TyG remained associated only with the earliest transition, and no AIP transition survived correction.

Among single-marker additions, eGDR yielded the largest point gain in discrimination (ΔC-index, 0.041; 95% CI, 0.027–0.055). Adding TyG to eGDR further increased the C-index by 0.012 (95% CI, 0.005–0.020), whereas adding AIP to eGDR plus TyG changed the C-index by 0.001 (95% CI, −0.003 to 0.005). Calibration slopes were 0.910–0.945.

Interval-aware and competing-risk analyses were consistent.</p>Conclusion<p>All three indices were associated with incident CMM. eGDR showed the most consistent transition associations and the numerically largest single-marker gain in internally validated prediction; TyG was complementary, whereas AIP added little beyond eGDR and TyG. Independent external validation and clinical-utility assessment are needed before use in early risk stratification.</p>