Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 3, 2026Cardiology ResearchOpen Access

Elevated cholesterol-HDL-glucose index is linked to ~46% higher stroke risk in non-diabetic adults.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does a higher Cholesterol-HDL-Glucose (CHG) index increase the risk of stroke in middle-aged and elderly adults without diabetes?

Population

13,433 middle-aged and elderly adults without diabetes from two national cohorts. CHARLS cohort: median age…

Comparison

Higher Cholesterol-HDL-Glucose index vs Lowest quartile of CHG index (Q1)

Design

Cohort

Follow-up

up to 9.0 years (CHARLS)

Key result

An elevated cholesterol-HDL-glucose index was independently associated with an increased risk of stroke in middle-aged and elderly adults without diabetes, with the highest quartile showing a 46.3% higher risk (HR 1.463) compared to the lowest quartile.

Authors

YJYu JingBLBen LinCGChen Yang Ge

Discussion

Loading...

Member takes

Overview

CHG index was associated with higher stroke risk in nondiabetic adults; leaves open its added value for stratification or need for prospective validation.

Key Points

  • To examine the association between the cholesterol–HDL–glucose (CHG) index and the risk of stroke among middle-aged and elderly adults without diabetes.
  • Analyzed data from two prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS, n = 8,376, 2011–2020) and the National Health and Nutrition Examination Survey (NHANES, n = 5,057, 2011–2018).
  • Evaluated incident stroke risk using multivariable Cox proportional hazard regression, restricted cubic spline models for non-linearity, ROC curves, and mediation analysis via HbA1c.
  • In the CHARLS cohort, 651 participants (7.77%) developed stroke over 9.0 years, with adjusted hazard ratios of 1.378 (95% CI: 1.073–1.771), 1.447 (95% CI: 1.137–1.842), and 1.463 (95% CI: 1.147–1.868) for CHG index quartiles 2, 3, and 4 versus quartile 1.
  • Restricted cubic spline analysis showed a significant linear relationship (P-nonlinearity > 0.05), and HbA1c mediated 13.33% of the association between the CHG index and stroke risk.
  • Validation in the NHANES cohort (n = 5,057) confirmed a significant positive correlation and stroke predictive ability comparable to the triglyceride–glucose (TyG) index.

Study Design

Type

Cohort (n=8,376)

Multicenter

Yes

Structured PICO

Does a higher Cholesterol-HDL-Glucose (CHG) index increase the risk of stroke in middle-aged and elderly adults without diabetes?

P
Population
8,376 middle-aged and elderly Chinese adults without diabetes, free of prior stroke, followed for up to 9.0 years.
E
Exposure
Higher Cholesterol-HDL-Glucose (CHG) index (analyzed as quartiles and continuous variable)
C
Comparator
Lowest quartile of CHG index (Q1)
O
Outcome
Incidence of stroke eventshard clinical

Main Result

Hazard Ratio: 1.463 (95% CI 1.147–1.868)

Absolute Event Rate: 10.18% vs 5.36%

p-value: p=0.002

The CHG index is a significant, independent predictor of incident stroke in middle-aged and older adults without diabetes, performing comparably to the TyG index.

Limitations

  • Stroke outcome was determined based on self-reported physician diagnosis, introducing potential recall bias and misclassification.
  • Basic stroke information restricts in-depth analysis of specific stroke subtypes.
  • Limited number of stroke events for some detailed subgroup analyses.
  • Direct generalizability to other ethnic populations may be constrained.
  • Absence of detailed information regarding drug classes and dosages may result in residual confounding.
  • Only evaluated baseline CHG index, ignoring continuous variations over time.

Cite This Study

Jing et al. (2026) conducted a cohort in Stroke risk in adults without diabetes (n=8,376). Cholesterol-HDL-glucose (CHG) index vs. Lowest quartile of CHG index was evaluated on Incidence of stroke (HR 1.463, 95% CI 1.147-1.868, p=0.002). An elevated cholesterol-HDL-glucose index was independently associated with an increased risk of stroke in middle-aged and elderly adults without diabetes, with the highest quartile showing a 46.3% higher risk (HR 1.463) compared to the lowest quartile.

synapsesocial.com/papers/6a993503636c6408cfa7ccdchttps://doi.org/10.14740/cr2258
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Associations Between the CHG Index, Its Modified Versions, and Incident Stroke in Early-Stage CKM Syndrome: A Nationwide Cohort Study2025
  2. 2Evaluating the role of CHG index in predicting stroke risk among adults with varying glucose regulation2025 · 12 citations
  3. 3Joint association of triglyceride-glucose index and atherogenic lipid markers with incident stroke risk2026
  4. 4Cholesterol-HDL-glucose index and type 2 diabetes risk in middle-aged and older adults: Evidence from a nationwide Chinese cohort2025 · 7 citations
  5. 5Association between the cholesterol, high-density lipoprotein, and glucose index and type 2 diabetes mellitus prevalence in US adults: A cross-sectional study based on National Health and Nutrition Examination Survey 2009–20182025 · 12 citations