Association Between Triglyceride-Glucose Index, Blood Pressure Status, and Coronary Heart Disease Risk Among Chinese Adults With Disabilities: 10-Year Disability Health Survey Cohort Study
Bibliographic record
Abstract
Background: The triglyceride-glucose (TyG) index and blood pressure (BP) status are key indicators associated with coronary heart disease (CHD). However, limited research has focused on individuals with disabilities. Objective: This study explores the potential combined effects of the TyG index and BP status on CHD risk in groups with varying disability characteristics. Methods: This study analyzed data from the Shanghai Disability Health Survey, conducted between January 2012 and December 2022. Participants were then categorized into 3 BP status groups: nonelevated BP, elevated BP, and hypertension. Cox proportional hazards regression models were used to assess the associations between BP status, the TyG index, and CHD incidence. Additionally, the mediating, interaction, and combined effects of these factors on CHD risk were examined. A stratified analysis was performed based on participants' disability characteristics, including disability type and severity, to explore potential variations in the associations. Results: Among the 21,628 participants, the mean age was 53.30 (SD 10.57) years, and 50.89% (11007/21628) were male. In a follow-up of 77.45 months, CHD events occurred in 2312 participants (10.69%). The TyG index and BP status were independently associated with an increased risk of CHD. Mediation analysis showed that TyG explained 20.5% (95% CI 13.6%-22.0%) of the BP and CHD association. Significant multiplicative interactions were identified (hazard ratio [HR] 1.41, 95% CI 1.02-1.94), and joint analysis indicated the highest CHD risk in those with both hypertension and elevated TyG (HR 1.92, 95% CI 1.52-2.42). Stratified analyses revealed stronger mediation in participants with physical disabilities (22.6%, 95% CI 9.0%-60%) or visual disabilities (16.6%, 95% CI 4.8%-51%), while this was not significant in those with hearing or speech (P=.07) or intellectual or mental disabilities (P=.13). By disability grading, the mediated proportion was 22.3% (95% CI 9.2%-59.4%) in mild or moderate and 18.8% (95% CI 15.7%-29%) in severe or very severe groups. Joint associations showed consistently higher CHD risk across most disability classifications, with particularly elevated risk in people with intellectual or mental disabilities (HR 3.51, 95% CI 1.89-6.50). Conclusions: BP and the TyG index were significantly associated with CHD risk in individuals with disabilities, with TyG mediating a part of this association and showing stronger effects in physical and mild to moderate disabilities. Significant interactions between BP and TyG further highlight their combined impact, underscoring the need for integrated interventions targeting both factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".