{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:41:41Z","timestamp":1792665701058,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The aim of this study was to investigate the association of baseline and changes of TyG\u2010BRI with incident CVD based on the UK Biobank and China Health and Retirement Longitudinal Study (CHARLS). A total of 418,510 and 7923 individuals from the UK Biobank and CHARLS were included in Analysis 1 (baseline TyG\u2010BRI with CVD risk). In Analysis 2 (change in TyG\u2010BRI with CVD risk), a total of 11,682 and 4637 participants were included in Cox proportional hazard models. We found participants with the highest baseline TyG\u2010BRI level were associated with increased risk of incident CVD in UK Biobank (HR\u2009=\u20091.45, 95% CI: 1.39\u20131.52) and CHARLS (HR\u2009=\u20091.35, 95% CI: 1.13\u20131.61). Multivariable\u2010adjusted restricted cubic spline analyses presented positive linear associations between TyG\u2010BRI and CVD risk. Compared to persistently low levels of TyG\u2010BRI (Class 1), those with persistently high levels (Class 3: 1.23 (1.02\u20131.49) and 1.42 (1.11\u20131.55); Class 4: 1.48 (1.17\u20131.87) and 1.45 (1.16\u20132.28); Class 5: 2.58 (1.86\u20133.58) and 1.63 (1.16\u20132.28) for UK Biobank and CHARLS) in follow\u2010up were associated with increased risks of incident CVD. In conclusion, a high baseline TyG\u2010BRI level and different changes in TyG\u2010BRI level are associated with increased risks of incident CVD.<\/jats:p>","DOI":"10.1002\/kjm2.70305","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:17:13Z","timestamp":1792664233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of the Baseline Level and Change in Triglyceride Glucose\u2010Body Roundness Index With Cardiovascular Diseases: Two Large Prospective Cohorts in Europe and Asia"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4915-9418","authenticated-orcid":false,"given":"Wen\u2010Yang","family":"Han","sequence":"first","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Public Health Research Center, Wuxi School of Medicine Jiangnan University  Wuxi Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Qun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Public Health Research Center, Wuxi School of Medicine Jiangnan University  Wuxi Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7327-3294","authenticated-orcid":false,"given":"Pin\u2010Ni","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3624-7879","authenticated-orcid":false,"given":"Yi\u2010Ming","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9927-0654","authenticated-orcid":false,"given":"Lu\u2010Lu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2725-5228","authenticated-orcid":false,"given":"Rui\u2010Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5883-0416","authenticated-orcid":false,"given":"Meng\u2010Yao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4842-4852","authenticated-orcid":false,"given":"Xiao\u2010Wei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Public Health Research Center, Wuxi School of Medicine Jiangnan University  Wuxi Jiangsu China"},{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-3490","authenticated-orcid":false,"given":"Yong\u2010Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Public Health Research Center, Wuxi School of Medicine Jiangnan University  Wuxi Jiangsu China"},{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-0014","authenticated-orcid":false,"given":"Zheng\u2010Bao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non\u2010Communicable Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health Suzhou Medical College of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"25","key":"e_1_2_10_2_1","first-page":"2982","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20102019: Update From the GBD 2019 Study","volume":"76","author":"Roth G. A.","year":"2020","journal-title":"Journal of the American College of Cardiology"},{"issue":"2","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1038\/s41569-021-00607-3","article-title":"Epidemiology of Cardiovascular Disease in Europe","volume":"19","author":"Townsend N.","year":"2022","journal-title":"Nature Reviews Cardiology"},{"issue":"12","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004111","article-title":"Addressing the Diagnostic Gap in Hypertension Through Possible Interventions and Scale\u2010Up: A Microsimulation Study","volume":"19","author":"Koeppel L.","year":"2022","journal-title":"PLoS Medicine"},{"issue":"9","key":"e_1_2_10_5_1","first-page":"949","article-title":"Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary","volume":"37","author":"National Center for Cardiovascular Diseases the Writing Committee of the Report on Cardiovascular Health and Diseases in China","year":"2024","journal-title":"Biomedical and Environmental Sciences"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1038\/s41569-018-0119-4","article-title":"Epidemiology of Cardiovascular Disease in China: Current Features and Implications","volume":"16","author":"Zhao D.","year":"2019","journal-title":"Nature Reviews Cardiology"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1161\/CIRCRESAHA.117.308903","article-title":"Reducing the Global Burden of Cardiovascular Disease, Part 1: The Epidemiology and Risk Factors","volume":"121","author":"Joseph P.","year":"2017","journal-title":"Circulation Research"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.pcad.2021.12.001","article-title":"The Importance of Healthy Lifestyle Behaviors in the Prevention of Cardiovascular Disease","volume":"70","author":"Kaminsky L. A.","year":"2022","journal-title":"Progress in Cardiovascular Diseases"},{"issue":"3","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.2337\/dc08-1195","article-title":"Natural History of Insulin Sensitivity and Insulin Secretion in the Progression From Normal Glucose Tolerance to Impaired Fasting Glycemia and Impaired Glucose Tolerance: The Inter99 Study","volume":"32","author":"Faerch K.","year":"2009","journal-title":"Diabetes Care"},{"issue":"5","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.cmet.2011.07.015","article-title":"Insulin Resistance, Hyperglycemia, and Atherosclerosis","volume":"14","author":"Bornfeldt K. E.","year":"2011","journal-title":"Cell Metabolism"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.2337\/diacare.23.1.57","article-title":"Homeostasis Model Assessment Closely Mirrors the Glucose Clamp Technique in the Assessment of Insulin Sensitivity: Studies in Subjects With Various Degrees of Glucose Tolerance and Insulin Sensitivity","volume":"23","author":"Bonora E.","year":"2000","journal-title":"Diabetes Care"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12933-022-01548-y","article-title":"TyG Index Is Positively Associated With Risk of CHD and Coronary Atherosclerosis Severity Among NAFLD Patients","volume":"21","author":"Zhao J.","year":"2022","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12933-022-01511-x","article-title":"Triglyceride\u2010Glucose Index as a Marker in Cardiovascular Diseases: Landscape and Limitations","volume":"21","author":"Tao L. C.","year":"2022","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12933-022-01507-7","article-title":"Prognostic Value of Triglyceride Glucose (TyG) Index in Patients With Acute Decompensated Heart Failure","volume":"21","author":"Huang R.","year":"2022","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12933-023-02002-3","article-title":"Association of Triglyceride\u2010Glucose Index Trajectory and Frailty in Urban Older Residents: Evidence From the 10\u2010Year Follow\u2010Up in a Cohort Study","volume":"22","author":"Yuan Y.","year":"2023","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12933-024-02209-y","article-title":"Associations of Triglyceride\u2010Glucose (TyG) Index With Chest Pain Incidence and Mortality Among the U.S. Population","volume":"23","author":"Zhao Y.","year":"2024","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s12933-023-02054-5","article-title":"Association of Triglyceride Glucose Index With All\u2010Cause and Cardiovascular Mortality in the General Population","volume":"22","author":"Chen J.","year":"2023","journal-title":"Cardiovascular Diabetology"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","DOI":"10.3389\/fnut.2024.1373039","article-title":"Triglyceride Glucose\u2010Related Indexes and Lipid Accumulation Products\u2010Reliable Markers of Insulin Resistance in the Chinese Population","volume":"11","author":"Liu L.","year":"2024","journal-title":"Frontiers in Nutrition"},{"issue":"1","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1186\/s12933-024-02354-4","article-title":"Association of Triglyceride Glucose\u2010Related Parameters With All\u2010Cause Mortality and Cardiovascular Disease in NAFLD Patients: NHANES 1999\u20102018","volume":"23","author":"Zhang Y.","year":"2024","journal-title":"Cardiovascular Diabetology"},{"issue":"11","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1002\/oby.20408","article-title":"Relationships Between Body Roundness With Body Fat and Visceral Adipose Tissue Emerging From a New Geometrical Model","volume":"21","author":"Thomas D. M.","year":"2013","journal-title":"Obesity"},{"issue":"12","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"5419","DOI":"10.1210\/jc.2010-1378","article-title":"Impact of Abdominal Visceral and Subcutaneous Adipose Tissue on Cardiometabolic Risk Factors: The Jackson Heart Study","volume":"95","author":"Liu J.","year":"2010","journal-title":"Journal of Clinical Endocrinology & Metabolism"},{"issue":"1","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"3301","DOI":"10.1186\/s12889-024-20631-5","article-title":"Evaluating a New Obesity Indicator for Stroke Risk Prediction: Comparative Cohort Analysis in Rural Settings of Two Nations","volume":"24","author":"Yao F.","year":"2024","journal-title":"BMC Public Health"},{"issue":"1","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s12933-023-01870-z","article-title":"The Change of Triglyceride\u2010Glucose Index May Predict Incidence of Stroke in the General Population Over 45\u2009Years Old","volume":"22","author":"Wu Y.","year":"2023","journal-title":"Cardiovascular Diabetology"},{"issue":"19","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.034768","article-title":"Body Roundness Index Trajectories and the Incidence of Cardiovascular Disease: Evidence From the China Health and Retirement Longitudinal Study","volume":"13","author":"Yang M.","year":"2024","journal-title":"Journal of the American Heart Association"},{"issue":"1","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1186\/s12933-023-01983-5","article-title":"Changes in the Triglyceride Glucose\u2010Body Mass Index Estimate the Risk of Stroke in Middle\u2010Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study","volume":"22","author":"Huo R. R.","year":"2023","journal-title":"Cardiovascular Diabetology"},{"issue":"1","key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1186\/s12933-024-02336-6","article-title":"Association Between Triglyceride Glucose\u2010Waist Height Ratio Index and Cardiovascular Disease in Middle\u2010Aged and Older Chinese Individuals: A Nationwide Cohort Study","volume":"23","author":"Ren Q.","year":"2024","journal-title":"Cardiovascular Diabetology"},{"issue":"3","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age","volume":"12","author":"Sudlow C.","year":"2015","journal-title":"PLoS Medicine"},{"issue":"1","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort Profile: The China Health and Retirement Longitudinal Study (CHARLS)","volume":"43","author":"Zhao Y.","year":"2014","journal-title":"International Journal of Epidemiology"},{"issue":"7","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"3347","DOI":"10.1210\/jc.2010-0288","article-title":"The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison With the Euglycemic\u2010Hyperinsulinemic Clamp","volume":"95","author":"Guerrero\u2010Romero F.","year":"2010","journal-title":"Journal of Clinical Endocrinology & Metabolism"},{"issue":"3","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0149731","article-title":"Triglyceride Glucose\u2010Body Mass Index Is a Simple and Clinically Useful Surrogate Marker for Insulin Resistance in Nondiabetic Individuals","volume":"11","author":"Er L. K.","year":"2016","journal-title":"PLoS One"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.procs.2022.12.146","article-title":"Clustering Models for Hospitals in Jakarta Using Fuzzy c\u2010Means and k\u2010Means","volume":"216","author":"Setiawan K. E.","year":"2023","journal-title":"Procedia Computer Science"},{"issue":"24","key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1161\/CIRCULATIONAHA.117.032432","article-title":"Associations of Fitness, Physical Activity, Strength, and Genetic Risk With Cardiovascular Disease: Longitudinal Analyses in the UK Biobank Study","volume":"137","author":"Tikkanen E.","year":"2018","journal-title":"Circulation"},{"key":"e_1_2_10_33_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2021.101264","article-title":"Association Between Sarcopenia and Cardiovascular Disease Among Middle\u2010Aged and Older Adults: Findings From the China Health and Retirement Longitudinal Study","volume":"44","author":"Gao K.","year":"2022","journal-title":"EClinicalMedicine"},{"issue":"1","key":"e_1_2_10_34_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/s12933-022-01546-0","article-title":"Relationship Between the Triglyceride\u2010Glucose Index and Risk of Cardiovascular Diseases and Mortality in the General Population: A Systematic Review and Meta\u2010Analysis","volume":"21","author":"Liu X.","year":"2022","journal-title":"Cardiovascular Diabetology"},{"issue":"3","key":"e_1_2_10_35_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu17030492","article-title":"The Association Between the Triglyceride\u2010Glucose Index, Its Combination With the Body Roundness Index, and Chronic Kidney Disease in Patients With Type 2 Diabetes in Eastern China: A Preliminary Study","volume":"17","author":"Chen X.","year":"2025","journal-title":"Nutrients"},{"issue":"1","key":"e_1_2_10_36_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12933-023-02100-2","article-title":"Relationship Between Triglyceride\u2010Glucose Index Baselines and Trajectories With Incident Cardiovascular Diseases in the Elderly Population","volume":"23","author":"Wang Y.","year":"2024","journal-title":"Cardiovascular Diabetology"},{"issue":"3","key":"e_1_2_10_37_1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1093\/ajcn\/nqab412","article-title":"Associations of Longitudinal Trajectories in Body Roundness Index With Mortality and Cardiovascular Outcomes: A Cohort Study","volume":"115","author":"Wu M.","year":"2022","journal-title":"American Journal of Clinical Nutrition"}],"container-title":["The Kaohsiung Journal of Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/kjm2.70305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/kjm2.70305","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/kjm2.70305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:17:18Z","timestamp":1792664238000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/kjm2.70305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":36,"alternative-id":["10.1002\/kjm2.70305"],"URL":"https:\/\/doi.org\/10.1002\/kjm2.70305","archive":["Portico"],"relation":{},"ISSN":["1607-551X","2410-8650"],"issn-type":[{"value":"1607-551X","type":"print"},{"value":"2410-8650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"assertion":[{"value":"2026-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70305"}}