Cholesterol-HDL-glucose index and type 2 diabetes risk in middle-aged and older adults: Evidence from a nationwide Chinese cohort

Type 2 diabetes mellitus (T2DM) poses a significant global health challenge. This study aims to evaluate the ability of the cholesterol-HDL-glucose (CHG) index, as a novel indicator, to predict the risk of type 2 diabetes in the Chinese population. We conducted the cross-sectional analyses using data from the China Health and Retirement Longitudinal Study. The cross-sectional analysis included 8251 participants from the 2011 baseline survey. Multivariate logistic regression and restricted cubic spline analyses were employed to examine the relationship between CHG and T2DM. Stratified analyses, based on covariates such as age and gender, were performed to explore the association between CHG and T2DM risk within various subgroups. The predictive performance and accuracy of CHG, compared with other lipid indices, were evaluated using receiver operating characteristic (ROC) curve analysis. In the cross-sectional analyses, each unit increase in CHG was associated with a 1.5-fold increase in the risk of T2DM after adjusting for all confounders. A nonlinear relationship was observed with a turning point at 5.28 mg/dL. In stratified analyses, CHG exhibited slightly superior predictive performance for T2DM compared to HbA1c. CHG demonstrated an area under the curve of 0.825 (95% CI: 0.812-0.839) for predicting T2DM risk in middle-aged and older Chinese adults. CHG serves as a simple, effective, and economical novel indicator that demonstrates robust predictive capability for T2DM among middle-aged and older adults in China. Although its predictive efficacy is slightly lower than that of the TyG index, it can still serve as another valuable tool for the early identification of T2DM in this population.