Insulin resistance markers like triglyceride-glucose (TyG) index and estimated glucose disposal rate (eGDR) link to cardiometabolic multimorbidity (CMM). Lipid markers such as atherogenic index of plasma (AIP) and remnant cholesterol (RC) need clearer roles. In a recent study published in the Cardiovascular Diabetology, the researchers tested individual and combined effects on CMM risk.

Data came from the English Longitudinal Study of Ageing. A composite index merged TyG, eGDR, AIP, and RC via principal component analysis. Among 4232 participants, multivariable Cox models checked ties to incident CMM over 6.8 years. ROC and net reclassification improvement (NRI) assessed prediction. Dose-response and subgroup analyses followed.

During follow-up, 552 CMM cases occurred. Each SD rise in TyG, AIP, RC tied to higher CMM risk: HR 1.308 (95% CI 1.202-1.422), 1.222 (1.117-1.338), 1.076 (1.025-1.129). Higher eGDR and composite index linked to lower risk: HR 0.650 (0.565-0.747), 0.626 (0.554-0.707). eGDR had 56.3% population attributable fraction (47.3-63.4%); composite 38.3% (29.8-47.8). Composite index gave best discrimination (AUC 0.754, NRI 0.066). Ties stronger under age 65.

In this ageing cohort, insulin resistance and lipid markers associated with CMM incidence. The composite index improved risk prediction modestly. Prospective findings highlight combined metabolic patterns, consistent across sexes, warranting further validation.