Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 17, Number 2, April 2026, pages 136-148

The Association Between Cholesterol, High-Density Lipoprotein, and Glucose Index and Mortality in Young and Middle-Aged Adults With Diabetes or Prediabetes: NHANES Data (1999–2018)

↓ Figure 2. (a–f) Restricted cubic spline models analyzed the relationship between cholesterol, high-density lipoprotein, glucose index, and mortality. CHG: cholesterol, high-density lipoprotein, and glucose; CI: confidence interval; CV: cardiovascular.

↓ **Table 1.** Baseline Characteristics of Study Individuals Aged ≤ 50 Years According to Quartiles of the CHG Index
Characteristic	Quartiles of CHG index	P value
ALT: alanine aminotransferase; AST: aspartate aminotransferase; BUN: blood urea nitrogen; CHG: cholesterol, high-density lipoprotein, and glucose; HDL: high-density lipoprotein cholesterol; LDH: lactate dehydrogenase; LDL-C: low-density lipoprotein cholesterol; HbA1C: hemoglobin A1c; TBil: total bilirubin; TC: total cholesterol; UA: uric acid; GGT: γ-glutamyl transferase; CRP: C-reactive protein; SCr: serum creatinine.
N	5,678	1,420	1,419	1,419	1,420
Age, years	38 (29, 45)	34 (24, 43)	36 (27, 44)	39 (31, 45)	40 (33, 45)	< 0.001
Family poverty income ratio	1.83 (0.96, 3.69)	1.86 (0.95, 3.72)	1.83 (0.94, 3.74)	1.87 (1.02, 3.81)	1.77 (0.95, 3.42)	0.202
BMI, kg/m²	29 (25, 34)	26 (23, 31)	29 (25, 34)	30 (27, 35)	31 (28, 36)	< 0.001
Waist circumference, cm	99 (90, 111)	90 (80, 102)	98 (89, 109)	102 (94, 113)	106 (97, 118)	< 0.001
Gender, n (%)						< 0.001
Female	2,380 (41.9%)	822 (57.9%)	629 (44.3%)	501 (35.3%)	428 (30.1%)
Male	3,298 (58.1%)	598 (42.1%)	790 (55.7%)	918 (64.7%)	992 (69.9%)
Race, n (%)						< 0.001
Mexican American	1,321 (23.3%)	266 (18.7%)	336 (23.7%)	349 (24.6%)	370 (26.1%)
Non-Hispanic Black	1,241 (21.9%)	453 (31.9%)	319 (22.5%)	246 (17.3%)	223 (15.7%)
Non-Hispanic White	1,955 (34.4%)	408 (28.7%)	481 (33.9%)	519 (36.6%)	547 (38.5%)
Other race	1,161 (20.4%)	293 (20.6%)	283 (19.9%)	305 (21.5%)	280 (19.7%)
Education, n (%)	5,258/5,678	1,247/1,420	1,246/1,419	1,355/1,419	1,374/1,420	< 0.001
Less than 9th grade	525 (10.0%)	88 (7.1%)	113 (8.8%)	143 (10.6%)	181 (13.2%)
9th–11th grade	895 (17.0%)	178 (14.3%)	219 (17.1%)	244 (18.0%)	254 (18.5%)
High school graduate or equivalent	1,244 (23.7%)	270 (21.7%)	287 (22.4%)	332 (24.5%)	355 (25.8%)
Some college or above	2,594 (49.3%)	711 (57.0%)	663 (51.7%)	636 (46.9%)	584 (42.5%)
Miss	420	173	137	64	46
Cerebrovascular disease, n (%)						< 0.001
Congestive heart failure	59 (1.1%)	12 (1.0%)	12 (0.9%)	11 (0.8%)	24 (1.7%)
Coronary heart disease	41 (0.8%)	8 (0.6%)	8 (0.6%)	9 (0.7%)	16 (1.2%)
Angina pectoris	49 (0.9%)	8 (0.6%)	8 (0.6%)	7 (0.5%)	26 (1.9%)
Myocardial infarction	69 (1.3%)	11 (0.9%)	11 (0.9%)	12 (0.9%)	35 (2.5%)
Stroke	63 (1.2%)	14 (1.1%)	9 (0.7%)	13 (1.0%)	27 (2.0%)
Diabetes status, n (%)						< 0.001
Diabetes	926 (16.3%)	72 (5.1%)	110 (7.8%)	175 (12.3%)	569 (40.1%)
Prediabetes	4,752 (83.7%)	1,348 (94.9%)	1,309 (92.2%)	1,244 (87.7%)	851 (59.9%)
Smoking status, n (%)	5,384/5,678	1,306/1,420				< 0.001
Current	1,430 (26.6%)	275 (21.1%)	352 (26.6%)	360 (26.2%)	443 (32.1%)
Former	914 (17.0%)	196 (15.0%)	208 (15.7%)	257 (18.7%)	253 (18.3%)
Never	3,040 (56.5%)	835 (63.9%)	763 (57.7%)	756 (55.1%)	686 (49.6%)
Miss	294	114	96	46	38
Hypertension, n (%)						< 0.001
No	4,298 (76.0%)	1,162 (82.2%)	1,097 (77.5%)	1,085 (77.1%)	954 (67.3%)
Yes	1,357 (24.0%)	252 (17.8%)	319 (22.5%)	323 (22.9%)	463 (32.7%)
Miss	23	6	3	11	3
Alcohol consumption, n (%)						< 0.001
Heavy	319 (6.0%)	85 (6.6%)	97 (7.4%)	70 (5.2%)	67 (4.9%)
Moderate	2,102 (39.6%)	382 (29.5%)	499 (38.3%)	593 (44.1%)	628 (46.1%)
Mild	2,276 (42.9%)	665 (51.3%)	556 (42.7%)	525 (39.0%)	530 (38.9%)
Never	609 (11.5%)	164 (12.7%)	151 (11.6%)	157 (11.7%)	137 (10.1%)
Miss	372	124	116	74	58
Laboratory measurements
TC, mg/dL	190 (165, 219)	166 (145, 189)	183 (162, 205)	197 (177, 223)	218 (192, 245)	< 0.001
TG, mmol/L	1.25 (0.85, 1.92)	0.75 (0.58, 1.03)	1.08 (0.82, 1.47)	1.45 (1.11, 1.94)	2.21 (1.58, 3.29)	< 0.001
HDLC, mmol/L	1.22 (1.01, 1.45)	1.58 (1.37, 1.81)	1.29 (1.14, 1.45)	1.11 (1.01, 1.24)	0.96 (0.84, 1.09)	< 0.001
LDLC, mmol/L	2.97 (2.38, 3.60)	2.30 (1.91, 2.73)	2.92 (2.46, 3.36)	3.28 (2.77, 3.83)	3.57 (2.97, 4.19)	< 0.001
HbA1C, %	5.60 (5.30, 5.80)	5.40 (5.20, 5.70)	5.50 (5.20, 5.70)	5.50 (5.30, 5.80)	5.80 (5.40, 7.00)	< 0.001
Fasting glucose, mg/dL	104 (101, 112)	101 (97, 105)	103 (100, 108)	105 (101, 111)	114 (105, 156)	< 0.001
Insulin, pmol/L	13 (8, 21)	9 (6, 14)	12 (7, 19)	14 (9, 22)	18 (12, 28)	< 0.001
TBil, umol/L	10.3 (8.6, 13.7)	10.3 (8.6, 13.7)	10.3 (8.6, 13.7)	10.3 (8.6, 13.7)	10.3 (8.6, 13.7)	0.024
LDH, mmol/L	127 (112, 145)	124 (110, 142)	126 (111, 145)	128 (113, 146)	129 (114, 147)	< 0.001
BUN, mmol/L	4.28 (3.21, 5.00)	3.93 (3.21, 5.00)	3.93 (3.21, 5.00)	4.28 (3.57, 5.00)	4.28 (3.57, 5.36)	< 0.001
UA, µmol/L	327 (274, 387)	286 (244, 339)	327 (274, 381)	345 (292, 405)	351 (296, 410)	< 0.001
SCr, µmol/L	72 (62, 84)	71 (59, 81)	72 (62, 85)	73 (63, 86)	72 (62, 86)	0.006
Serum iron, µmol/L	15 (11, 19)	14 (10, 19)	15 (11, 19)	15 (11, 19)	15 (11, 19)	0.401
Serum potassium, mmol/L	4.00 (3.80, 4.20)	3.98 (3.80, 4.20)	4.00 (3.80, 4.20)	4.00 (3.80, 4.20)	4.00 (3.80, 4.20)	< 0.001
GGT, IU/L	23 (16, 35)	17 (12, 24)	21 (15, 30)	25 (18, 37)	31 (22, 48)	< 0.001
AST, IU/L	23 (19, 28)	21 (18, 26)	22 (19, 27)	23 (19, 29)	25 (20, 31)	< 0.001
ALT, IU/L	23 (17, 34)	18 (14, 24)	22 (17, 31)	26 (19, 37)	30 (21, 44)	< 0.001
CRP, mmol/L	0.42 (0.14, 1.45)	0.31 (0.08, 1.13)	0.42 (0.12, 1.51)	0.46 (0.15, 1.42)	0.51 (0.21, 1.62)	0.177

↓ Table 1. Baseline Characteristics of Study Individuals Aged ≤ 50 Years According to Quartiles of the CHG Index

Characteristic

Quartiles of CHG index

P value

Overall

Q1 (3.07, 5.12)

Q2 (5.12, 5.37)

Q3 (5.37, 5.64)

Q4 (5.64, 8.02)

ALT: alanine aminotransferase; AST: aspartate aminotransferase; BUN: blood urea nitrogen; CHG: cholesterol, high-density lipoprotein, and glucose; HDL: high-density lipoprotein cholesterol; LDH: lactate dehydrogenase; LDL-C: low-density lipoprotein cholesterol; HbA1C: hemoglobin A1c; TBil: total bilirubin; TC: total cholesterol; UA: uric acid; GGT: γ-glutamyl transferase; CRP: C-reactive protein; SCr: serum creatinine.

5,678

1,420

1,419

1,420

Age, years

38 (29, 45)

34 (24, 43)

36 (27, 44)

39 (31, 45)

40 (33, 45)

< 0.001

Family poverty income ratio

1.83 (0.96, 3.69)

1.86 (0.95, 3.72)

1.83 (0.94, 3.74)

1.87 (1.02, 3.81)

1.77 (0.95, 3.42)

0.202

BMI, kg/m²

29 (25, 34)

26 (23, 31)

29 (25, 34)

30 (27, 35)

31 (28, 36)

< 0.001

Waist circumference, cm

99 (90, 111)

90 (80, 102)

98 (89, 109)

102 (94, 113)

106 (97, 118)

< 0.001

Gender, n (%)

< 0.001

Female

2,380 (41.9%)

822 (57.9%)

629 (44.3%)

501 (35.3%)

428 (30.1%)

Male

3,298 (58.1%)

598 (42.1%)

790 (55.7%)

918 (64.7%)

992 (69.9%)

Race, n (%)

< 0.001

Mexican American

1,321 (23.3%)

266 (18.7%)

336 (23.7%)

349 (24.6%)

370 (26.1%)

Non-Hispanic Black

1,241 (21.9%)

453 (31.9%)

319 (22.5%)

246 (17.3%)

223 (15.7%)

Non-Hispanic White

1,955 (34.4%)

408 (28.7%)

481 (33.9%)

519 (36.6%)

547 (38.5%)

Other race

1,161 (20.4%)

293 (20.6%)

283 (19.9%)

305 (21.5%)

280 (19.7%)

Education, n (%)

5,258/5,678

1,247/1,420

1,246/1,419

1,355/1,419

1,374/1,420

< 0.001

Less than 9th grade

525 (10.0%)

88 (7.1%)

113 (8.8%)

143 (10.6%)

181 (13.2%)

9th–11th grade

895 (17.0%)

178 (14.3%)

219 (17.1%)

244 (18.0%)

254 (18.5%)

High school graduate or equivalent

1,244 (23.7%)

270 (21.7%)

287 (22.4%)

332 (24.5%)

355 (25.8%)

Some college or above

2,594 (49.3%)

711 (57.0%)

663 (51.7%)

636 (46.9%)

584 (42.5%)

Miss

420

173

137

Cerebrovascular disease, n (%)

< 0.001

Congestive heart failure

59 (1.1%)

12 (1.0%)

12 (0.9%)

11 (0.8%)

24 (1.7%)

Coronary heart disease

41 (0.8%)

8 (0.6%)

9 (0.7%)

16 (1.2%)

Angina pectoris

49 (0.9%)

8 (0.6%)

7 (0.5%)

26 (1.9%)

Myocardial infarction

69 (1.3%)

11 (0.9%)

12 (0.9%)

35 (2.5%)

Stroke

63 (1.2%)

14 (1.1%)

9 (0.7%)

13 (1.0%)

27 (2.0%)

Diabetes status, n (%)

< 0.001

Diabetes

926 (16.3%)

72 (5.1%)

110 (7.8%)

175 (12.3%)

569 (40.1%)

Prediabetes

4,752 (83.7%)

1,348 (94.9%)

1,309 (92.2%)

1,244 (87.7%)

851 (59.9%)

Smoking status, n (%)

5,384/5,678

1,306/1,420

< 0.001

Current

1,430 (26.6%)

275 (21.1%)

352 (26.6%)

360 (26.2%)

443 (32.1%)

Former

914 (17.0%)

196 (15.0%)

208 (15.7%)

257 (18.7%)

253 (18.3%)

Never

3,040 (56.5%)

835 (63.9%)

763 (57.7%)

756 (55.1%)

686 (49.6%)

Miss

294

114

Hypertension, n (%)

< 0.001

4,298 (76.0%)

1,162 (82.2%)

1,097 (77.5%)

1,085 (77.1%)

954 (67.3%)

Yes

1,357 (24.0%)

252 (17.8%)

319 (22.5%)

323 (22.9%)

463 (32.7%)

Miss

Alcohol consumption, n (%)

< 0.001

Heavy

319 (6.0%)

85 (6.6%)

97 (7.4%)

70 (5.2%)

67 (4.9%)

Moderate

2,102 (39.6%)

382 (29.5%)

499 (38.3%)

593 (44.1%)

628 (46.1%)

Mild

2,276 (42.9%)

665 (51.3%)

556 (42.7%)

525 (39.0%)

530 (38.9%)

Never

609 (11.5%)

164 (12.7%)

151 (11.6%)

157 (11.7%)

137 (10.1%)

Miss

372

124

116

Laboratory measurements

TC, mg/dL

190 (165, 219)

166 (145, 189)

183 (162, 205)

197 (177, 223)

218 (192, 245)

< 0.001

TG, mmol/L

1.25 (0.85, 1.92)

0.75 (0.58, 1.03)

1.08 (0.82, 1.47)

1.45 (1.11, 1.94)

2.21 (1.58, 3.29)

< 0.001

HDLC, mmol/L

1.22 (1.01, 1.45)

1.58 (1.37, 1.81)

1.29 (1.14, 1.45)

1.11 (1.01, 1.24)

0.96 (0.84, 1.09)

< 0.001

LDLC, mmol/L

2.97 (2.38, 3.60)

2.30 (1.91, 2.73)

2.92 (2.46, 3.36)

3.28 (2.77, 3.83)

3.57 (2.97, 4.19)

< 0.001

HbA1C, %

5.60 (5.30, 5.80)

5.40 (5.20, 5.70)

5.50 (5.20, 5.70)

5.50 (5.30, 5.80)

5.80 (5.40, 7.00)

< 0.001

Fasting glucose, mg/dL

104 (101, 112)

101 (97, 105)

103 (100, 108)

105 (101, 111)

114 (105, 156)

< 0.001

Insulin, pmol/L

13 (8, 21)

9 (6, 14)

12 (7, 19)

14 (9, 22)

18 (12, 28)

< 0.001

TBil, umol/L

10.3 (8.6, 13.7)

0.024

LDH, mmol/L

127 (112, 145)

124 (110, 142)

126 (111, 145)

128 (113, 146)

129 (114, 147)

< 0.001

BUN, mmol/L

4.28 (3.21, 5.00)

3.93 (3.21, 5.00)

4.28 (3.57, 5.00)

4.28 (3.57, 5.36)

< 0.001

UA, µmol/L

327 (274, 387)

286 (244, 339)

327 (274, 381)

345 (292, 405)

351 (296, 410)

< 0.001

SCr, µmol/L

72 (62, 84)

71 (59, 81)

72 (62, 85)

73 (63, 86)

72 (62, 86)

0.006

Serum iron, µmol/L

15 (11, 19)

14 (10, 19)

15 (11, 19)

0.401

Serum potassium, mmol/L

4.00 (3.80, 4.20)

3.98 (3.80, 4.20)

4.00 (3.80, 4.20)

< 0.001

GGT, IU/L

23 (16, 35)

17 (12, 24)

21 (15, 30)

25 (18, 37)

31 (22, 48)

< 0.001

AST, IU/L

23 (19, 28)

21 (18, 26)

22 (19, 27)

23 (19, 29)

25 (20, 31)

< 0.001

ALT, IU/L

23 (17, 34)

18 (14, 24)

22 (17, 31)

26 (19, 37)

30 (21, 44)

< 0.001

CRP, mmol/L

0.42 (0.14, 1.45)

0.31 (0.08, 1.13)

0.42 (0.12, 1.51)

0.46 (0.15, 1.42)

0.51 (0.21, 1.62)

0.177

↓ **Table 2.** The Association of the CHG Index With Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years and > 50 Years
Characteristic	Model 1	Model 2	Model 3
Model 1: no covariates were adjusted. Model 2 accounted for age, race, gender, education level, and family income-poverty ratio. Model 3: model 2 + hypertension, CVD (coronary heart disease, congestive heart failure, myocardial infarction, angina pectoris, stroke), smoking status, and alcohol consumption. HR: hazard ratio; CI: confidence interval; CHG: cholesterol, high-density lipoprotein, and glucose; CV: cardiovascular.
All–cause mortality
Diabetes or prediabetes with 18–50 years
CHG index (continuous)	2.46	1.94–3.12	< 0.001	2.06	1.57–2.69	< 0.001	1.86	1.40–2.47	< 0.001
CHG index
Q1	1 (reference)			1 (reference)			1 (reference)
Q2	1.23	0.77–1.95	0.383	1.05	0.64–1.72	0.841	0.96	0.58–1.59	0.885
Q3	1.24	0.79–1.95	0.359	1.03	0.63–1.66	0.920	0.95	0.58–1.56	0.840
Q4	2.66	1.78–3.96	< 0.001	2.02	1.30–3.12	0.002	1.68	1.06–2.65	0.026
P for trend			< 0.001			< 0.001			0.005
Diabetes or prediabetes with 51–85 years
CHG index (continuous)	1.00	0.92–1.10	0.929	1.21	1.09–1.33	< 0.001	1.21	1.09–1.35	< 0.001
CHG index
Q1	1 (reference)			1 (reference)			1 (reference)
Q2	0.80	0.71–0.90	< 0.001	0.84	0.74–0.94	0.004	0.84	0.74–0.95	0.005
Q3	0.77	0.68–0.86	< 0.001	0.81	0.72–0.92	< 0.001	0.82	0.72–0.93	0.002
Q4	0.92	0.83–1.03	0.149	1.09	0.97–1.23	0.134	1.10	0.97–1.24	0.144
P for trend			0.209			0.139			0.125
CV mortality
Diabetes or prediabetes with 18–50 years
CHG index (continuous)	3.26	2.11–5.04	< 0.001	2.81	1.76–4.49	< 0.001	2.54	1.55–4.15	< 0.001
CHG index
Q1	1 (reference)			1 (reference)			1 (reference)
Q2	1.72	0.58–5.13	0.332	1.48	0.49–4.45	0.485	1.23	0.40–3.81	0.723
Q3	2.10	0.74–5.96	0.164	1.62	0.56–4.69	0.372	1.46	0.50–4.29	0.494
Q4	4.77	1.84–12.3	0.001	3.45	1.29–9.22	0.013	2.69	0.98–7.36	0.054
P for trend			< 0.001			0.003			0.015
Diabetes or prediabetes with 51–85 years
CHG index (continuous)	1.09	0.93–1.27	0.281	1.41	1.19–1.67	< 0.001	1.32	1.10–1.59	0.003
CHG index
Q1	1 (reference)			1 (reference)			1 (reference)
Q2	0.78	0.64, 0.95	0.013	0.80	0.65, 0.99	0.036	0.78	0.63, 0.97	0.028
Q3	0.76	0.63, 0.93	0.006	0.83	0.67, 1.02	0.074	0.79	0.63, 0.98	0.031
Q4	0.96	0.79, 1.15	0.634	1.20	0.98, 1.47	0.072	1.14	0.92, 1.41	0.221
P for trend			0.795			0.053			0.180

↓ Table 2. The Association of the CHG Index With Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years and > 50 Years

Characteristic

Model 1

Model 2

Model 3

95% CI

P value

95% CI

P value

95% CI

P value

Model 1: no covariates were adjusted. Model 2 accounted for age, race, gender, education level, and family income-poverty ratio. Model 3: model 2 + hypertension, CVD (coronary heart disease, congestive heart failure, myocardial infarction, angina pectoris, stroke), smoking status, and alcohol consumption. HR: hazard ratio; CI: confidence interval; CHG: cholesterol, high-density lipoprotein, and glucose; CV: cardiovascular.

All–cause mortality

Diabetes or prediabetes with 18–50 years

CHG index (continuous)

2.46

1.94–3.12

< 0.001

2.06

1.57–2.69

< 0.001

1.86

1.40–2.47

< 0.001

CHG index

1 (reference)

1.23

0.77–1.95

0.383

1.05

0.64–1.72

0.841

0.96

0.58–1.59

0.885

1.24

0.79–1.95

0.359

1.03

0.63–1.66

0.920

0.95

0.58–1.56

0.840

2.66

1.78–3.96

< 0.001

2.02

1.30–3.12

0.002

1.68

1.06–2.65

0.026

P for trend

< 0.001

0.005

Diabetes or prediabetes with 51–85 years

CHG index (continuous)

1.00

0.92–1.10

0.929

1.21

1.09–1.33

< 0.001

1.21

1.09–1.35

< 0.001

CHG index

1 (reference)

0.80

0.71–0.90

< 0.001

0.84

0.74–0.94

0.004

0.84

0.74–0.95

0.005

0.77

0.68–0.86

< 0.001

0.81

0.72–0.92

< 0.001

0.82

0.72–0.93

0.002

0.92

0.83–1.03

0.149

1.09

0.97–1.23

0.134

1.10

0.97–1.24

0.144

P for trend

0.209

0.139

0.125

CV mortality

Diabetes or prediabetes with 18–50 years

CHG index (continuous)

3.26

2.11–5.04

< 0.001

2.81

1.76–4.49

< 0.001

2.54

1.55–4.15

< 0.001

CHG index

1 (reference)

1.72

0.58–5.13

0.332

1.48

0.49–4.45

0.485

1.23

0.40–3.81

0.723

2.10

0.74–5.96

0.164

1.62

0.56–4.69

0.372

1.46

0.50–4.29

0.494

4.77

1.84–12.3

0.001

3.45

1.29–9.22

0.013

2.69

0.98–7.36

0.054

P for trend

< 0.001

0.003

0.015

Diabetes or prediabetes with 51–85 years

CHG index (continuous)

1.09

0.93–1.27

0.281

1.41

1.19–1.67

< 0.001

1.32

1.10–1.59

0.003

CHG index

1 (reference)

0.78

0.64, 0.95

0.013

0.80

0.65, 0.99

0.036

0.78

0.63, 0.97

0.028

0.76

0.63, 0.93

0.006

0.83

0.67, 1.02

0.074

0.79

0.63, 0.98

0.031

0.96

0.79, 1.15

0.634

1.20

0.98, 1.47

0.072

1.14

0.92, 1.41

0.221

P for trend

0.795

0.053

0.180

↓ **Table 3.** Subgroup Analysis of CHG Index in Predicting All-Cause Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years
Subgroup	N	HR (95% CI)	P value	P for interaction
CHG: cholesterol, high-density lipoprotein, and glucose; HR: hazard ratio; CI: confidence interval.
Overall	5,678	2.46 (1.94–3.12)	< 0.001
Age (years)				0.054
< 35	2,283	3.54 (2.05–6.09)	< 0.001
≥ 35	3,395	1.94 (1.46–2.56)	< 0.001
Gender				0.641
Female	2,380	2.66 (1.77–4.00)	< 0.001
Male	3,298	2.34 (1.73–3.16)	< 0.001
Race				0.75
Mexican American	1,321	2.89 (1.50–5.58)	0.001
Non-Hispanic Black	1,241	2.17 (1.42–3.32)	< 0.001
Non-Hispanic White	1,955	2.90 (2.03–4.15)	< 0.001
Other race	1,161	2.25 (1.01–4.99)	0.047
Education level				0.2
Less than 9th grade	525	1.26 (0.52–3.09)	0.611
9th–11th grade	895	1.96 (1.21–3.18)	0.006
High school graduate or equivalent	1,244	3.24 (1.97–5.32)	< 0.001
Some college or above	2,594	2.64 (1.75–3.97)	< 0.001
Cerebrovascular disease				0.051
No	5,482	2.50 (1.93–3.24)	< 0.001
Yes	196	1.23 (0.63–2.42)	0.543
Smoking status				0.206
Current	1,430	2.01 (1.41–2.87)	< 0.001
Former	914	1.75 (0.93–3.31)	0.082
Never	3,040	3.15 (2.04–4.84)	< 0.001
Hypertension				0.3
No	4,298	2.49 (1.79–3.45)	< 0.001
Yes	1,357	1.91 (1.31–2.77)	0.001
Alcohol consumption				0.283
Heavy	319	0.88 (0.08–10.12)	0.92
Moderate	2,102	1.98 (1.30–3.03)	0.001
Mild	2,276	2.67 (1.88–3.80)	< 0.001
Never	609	3.93 (2.12–7.28)	< 0.001

↓ Table 3. Subgroup Analysis of CHG Index in Predicting All-Cause Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years

Subgroup

HR (95% CI)

P value

P for interaction

CHG: cholesterol, high-density lipoprotein, and glucose; HR: hazard ratio; CI: confidence interval.

Overall

5,678

2.46 (1.94–3.12)

< 0.001

Age (years)

0.054

< 35

2,283

3.54 (2.05–6.09)

< 0.001

≥ 35

3,395

1.94 (1.46–2.56)

< 0.001

Gender

0.641

Female

2,380

2.66 (1.77–4.00)

< 0.001

Male

3,298

2.34 (1.73–3.16)

< 0.001

Race

0.75

Mexican American

1,321

2.89 (1.50–5.58)

0.001

Non-Hispanic Black

1,241

2.17 (1.42–3.32)

< 0.001

Non-Hispanic White

1,955

2.90 (2.03–4.15)

< 0.001

Other race

1,161

2.25 (1.01–4.99)

0.047

Education level

0.2

Less than 9th grade

525

1.26 (0.52–3.09)

0.611

9th–11th grade

895

1.96 (1.21–3.18)

0.006

High school graduate or equivalent

1,244

3.24 (1.97–5.32)

< 0.001

Some college or above

2,594

2.64 (1.75–3.97)

< 0.001

Cerebrovascular disease

0.051

5,482

2.50 (1.93–3.24)

< 0.001

Yes

196

1.23 (0.63–2.42)

0.543

Smoking status

0.206

Current

1,430

2.01 (1.41–2.87)

< 0.001

Former

914

1.75 (0.93–3.31)

0.082

Never

3,040

3.15 (2.04–4.84)

< 0.001

Hypertension

0.3

4,298

2.49 (1.79–3.45)

< 0.001

Yes

1,357

1.91 (1.31–2.77)

0.001

Alcohol consumption

0.283

Heavy

319

0.88 (0.08–10.12)

0.92

Moderate

2,102

1.98 (1.30–3.03)

0.001

Mild

2,276

2.67 (1.88–3.80)

< 0.001

Never

609

3.93 (2.12–7.28)

< 0.001

↓ **Table 4.** Subgroup Analysis of CHG Index in Predicting Cardiovascular Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years
Subgroup	N	HR (95% CI)	P value	P for interaction
CHG: cholesterol, high-density lipoprotein, and glucose; HR: hazard ratio; CI: confidence interval.
Overall	5,678	3.26 (2.11–5.04)	< 0.001
Age (years)				0.037
< 35	2,283	6.57 (2.93–14.71)	< 0.001
≥ 35	3,395	2.33 (1.36–3.99)	0.002
Gender				0.927
Female	2,380	3.02 (1.08–8.42)	0.035
Male	3,298	3.10 (1.89–5.10)	< 0.001
Race				0.403
Mexican American	1,321	6.05 (2.14–17.06)	0.001
Non-Hispanic Black	1,241	2.33 (1.14–4.76)	0.02
Non-Hispanic White	1,955	4.13 (2.00–8.55)	< 0.001
Other race	1,161	5.12 (1.09–24.09)	0.039
Education level				0.229
Less than 9th grade	525	1.76 (0.18–17.05)	0.624
9th–11th grade	895	1.68 (0.67–4.22)	0.27
High school graduate or equivalent	1,244	5.26 (2.21–12.50)	< 0.001
Some college or above	2,594	4.05 (2.08–7.88)	< 0.001
Cerebrovascular disease				0.082
No	5,482	3.53 (2.19–5.69)	< 0.001
Yes	196	1.23 (0.40–3.73)	0.718
Smoking status				0.249
Current	1,430	2.36 (1.16–4.83)	0.018
Former	914	1.93 (0.54–6.89)	0.309
Never	3,040	4.76 (2.47–9.14)	< 0.001
Hypertension				0.096
No	4,298	4.14 (2.34–7.34)	< 0.001
Yes	1,357	1.91 (0.94–3.88)	0.072
Alcohol consumption				0.725
Moderate/heavy	2,421	2.58 (1.23–5.44)	0.013
Mild	2,276	3.66 (1.84–7.27)	< 0.001
Never	609	3.77 (1.44–9.81)	0.007

↓ Table 4. Subgroup Analysis of CHG Index in Predicting Cardiovascular Mortality in Individuals With Diabetes or Prediabetes ≤ 50 Years

Subgroup

HR (95% CI)

P value

P for interaction

CHG: cholesterol, high-density lipoprotein, and glucose; HR: hazard ratio; CI: confidence interval.

Overall

5,678

3.26 (2.11–5.04)

< 0.001

Age (years)

0.037

< 35

2,283

6.57 (2.93–14.71)

< 0.001

≥ 35

3,395

2.33 (1.36–3.99)

0.002

Gender

0.927

Female

2,380

3.02 (1.08–8.42)

0.035

Male

3,298

3.10 (1.89–5.10)

< 0.001

Race

0.403

Mexican American

1,321

6.05 (2.14–17.06)

0.001

Non-Hispanic Black

1,241

2.33 (1.14–4.76)

0.02

Non-Hispanic White

1,955

4.13 (2.00–8.55)

< 0.001

Other race

1,161

5.12 (1.09–24.09)

0.039

Education level

0.229

Less than 9th grade

525

1.76 (0.18–17.05)

0.624

9th–11th grade

895

1.68 (0.67–4.22)

0.27

High school graduate or equivalent

1,244

5.26 (2.21–12.50)

< 0.001

Some college or above

2,594

4.05 (2.08–7.88)

< 0.001

Cerebrovascular disease

0.082

5,482

3.53 (2.19–5.69)

< 0.001

Yes

196

1.23 (0.40–3.73)

0.718

Smoking status

0.249

Current

1,430

2.36 (1.16–4.83)

0.018

Former

914

1.93 (0.54–6.89)

0.309

Never

3,040

4.76 (2.47–9.14)

< 0.001

Hypertension

0.096

4,298

4.14 (2.34–7.34)

< 0.001

Yes

1,357

1.91 (0.94–3.88)

0.072

Alcohol consumption

0.725

Moderate/heavy

2,421

2.58 (1.23–5.44)

0.013

Mild

2,276

3.66 (1.84–7.27)

< 0.001

Never

609

3.77 (1.44–9.81)

0.007