Data Sheet 1_Association of the triglyceride-glucose index with dynamic bidirectional transitions of cardiovascular-kidney-metabolic syndrome: a multistate Markov model study based on CHARLS.docx

The predicted 4-year probabilities of transition to CKM stage 4 among participants initially in stages 0, 1, 2, and 3 were 8.3%, 8.8%, 12.0%, and 13.9%, respectively. The expected sojourn time increased from 1.97 years in stage 0 to 10.64 years in stage 3. In the multivariable-adjusted two-state model, compared with the lowest TyG tertile, the HRs for progression from the low-risk to the high-risk CKM state were 1.15 (95% CI: 0.96–1.37) for T2 and 1.35 (95% CI: 1.11–1.65) for T3.

Restricted cubic spline analysis showed a significant linear positive association between the TyG index and CKM progression risk. No significant association was observed between the TyG index and reversal from the high-risk to the low-risk CKM state.</p>Conclusion<p>CKM exhibited a clear dynamic evolutionary pattern, with greater transition activity at earlier stages and increasing persistence at more advanced stages. Higher TyG levels were associated with progression from the low-risk to the high-risk CKM state but not with CKM reversal.

The TyG index may provide complementary information for identifying individuals at increased risk of CKM progression.</p>