TyG‐HDL Outperforms TyG Combined With Obesity Indicators in Predicting Chronic Kidney Disease Associated With High Fasting Blood Glucose Levels in the Chinese Elderly Population: A Two‐Stage Study Based on GBD 2023 and CHARLS Data

Abstract

Background Chronic kidney disease (CKD) is a major public health issue in China, especially among older adults, with rising prevalence linked to metabolic disorders such as hyperglycemia. This study aimed to assess the burden of CKD attributable to elevated fasting blood glucose (FBG) in elderly Chinese, focusing on the predictive value of composite metabolic indices derived from the triglyceride‐glucose (TyG) index. Method The study included two phases: (1) analysis of the 2023 Global Burden of Disease (GBD) database to assess the CKD burden due to hyperglycemia among adults aged ≥ 60 years in China from 1990 to 2023 and (2) evaluation using the China Health and Retirement Longitudinal Study (CHARLS) cohort, analyzing associations between 15 blood glucose‐related indices and CKD in older adults. Results The GBD analysis revealed a significant burden of CKD due to hyperglycemia in China, with increasing mortality and disability‐adjusted life years (DALYs) projections. In the CHARLS cohort, four indices—TyG‐HDL, TCBI, FBG‐HDL, and CTI—were significantly associated with CKD. Elevated levels of these indices, particularly TyG‐HDL, demonstrated strong associations with CKD risk, with nonlinear, threshold‐dependent effects observed in restricted cubic spline analyses. Conclusion Blood glucose‐related indices, especially TyG‐HDL, offer strong predictive value for CKD risk in older Chinese adults. These findings suggest that integrating these indices into screening programs could enhance early CKD detection and management strategies, helping mitigate the growing disease burden in aging populations.