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oai:figshare.com:article/34008651 2026-09-28T04:35:10Z category_393 portal_316 item_type_3 month_year_09_2026

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 Xiunan Liu (24732070) Buyuan Tian (24732079) Hongwei Leng (23276830) Xumao Deng (24732076) Yun Sun (451368) Xiang Xiao (44417) Foetal Development and Medicine cardiovascular-kidney-metabolic syndrome CKM progression middle-aged and older adults multistate Markov model triglyceride-glucose index Objective<p>To characterize dynamic transitions across cardiovascular-kidney-metabolic (CKM) stages and examine the associations of the TyG index with bidirectional transitions between low- and high-risk CKM states among middle-aged and older adults.</p>Methods<p>Data were obtained from CHARLS. A continuous-time multistate Markov model was used to estimate transition intensities, predicted transition probabilities, and expected sojourn times across CKM stages 0−4. A two-state Markov model was further constructed by defining CKM stages 0−2 as the low-risk state and stages 3–4 as the high-risk state to evaluate the associations of the TyG index with CKM progression and reversal.</p>Results<p>A total of 5,135 participants were included. CKM stages 0–3 exhibited clear bidirectional transitions, with more active transitions at earlier stages and longer expected sojourn times at higher stages. 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> 2026-09-28T04:35:10Z Dataset Dataset 10.3389/fmed.2026.1912039.s001 https://figshare.com/articles/dataset/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/34008651 CC BY 4.0