{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:53:11Z","timestamp":1791355991927,"version":"4.3.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Prior studies have focused exclusively on baseline single\u2010point insulin sensitivity estimator (SPISE) index levels, and the prognostic impact of longitudinal SPISE index trajectories on incident cardiovascular disease (CVD) remains unclear, particularly among individuals with cardiovascular\u2013kidney\u2013metabolic syndrome stages 0 to 3. This study investigated the prognostic value of dynamic SPISE index changes for CVD risk in this preclinical population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This prospective cohort study used data from the CHARLS (China Health and Retirement Longitudinal Study). The SPISE index was calculated using body mass index, triglycerides, and high\u2010density lipoprotein cholesterol. We assessed longitudinal SPISE trajectories and cumulative SPISE index exposure by comparing measurements from wave 1 (baseline) and wave 3. Multivariable Cox proportional hazards models were used to evaluate associations of baseline, cumulative, and dynamic SPISE index profiles with incident CVD risk among participants at cardiovascular\u2013kidney\u2013metabolic stages 0 to 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The longitudinal cohort comprised 7982 participants, and the cumulative exposure subcohort included 5288 participants. Compared with those with persistently high SPISE index, participants with SPISE index deterioration from high to low had significantly elevated CVD risk (hazard ratio [HR], 1.28 [95% CI, 1.06\u20131.53]), similar to those with a persistently low SPISE index (HR, 1.36 [95% CI, 1.18\u20131.56]). Participants in the highest tertiles of baseline and cumulative SPISE index had 22% and 29% lower CVD risk, respectively, with significant effect modification by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among individuals in cardiovascular\u2013kidney\u2013metabolic syndrome stages 0 to 3, both baseline and cumulative SPISE indices are independently and inversely associated with incident CVD risk, with this protective effect being particularly pronounced in men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051048","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:42:44Z","timestamp":1790311364000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Variations in Single\u2010Point Insulin Sensitivity 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