Joint Association of Triglyceride-Glucose Index and a Body Shape Index With Risk of Cardiovascular Disease Among Adults With Prediabetes.

BACKGROUND: Individuals with prediabetes have a higher cardiovascular disease (CVD) risk than those with normoglycemia. Identifying high-risk subgroups is crucial for targeted prevention. While the triglyceride-glucose index (TyG) and a body shape index (ABSI) are independently linked to CVD risk, their combined utility in individuals with prediabetes remains unexplored. This study aimed to investigate whether concurrent high TyG and ABSI confer an additive CVD risk in this population. METHODS: We analyzed 6833 UK Biobank participants with prediabetes and no baseline CVD. Cox proportional hazards models were used to assess the associations between TyG, ABSI, and CVD incidence, adjusting for sociodemographic and metabolic confounders. Predictive performance was evaluated using the area under the curve (AUC) of receiver operating characteristic curves. RESULTS: Over a median 9.5-year follow-up, 840 participants developed CVD. Elevated TyG (hazard ratio [HR] = 1.09, 95% confidence interval [CI]: 1.01-1.25) and the highest ABSI quartile (HR = 1.54, 95% CI: 1.22-1.94) showed independent associations with CVD risk. Combined high TyG/high ABSI conferred an additive risk (HR = 1.65, 95% CI: 1.24-2.20), an effect more pronounced in hypertensive participants than in normotensive individuals (p for interaction = 0.018). The dual-marker method showed better discriminative performance for CVD (AUC = 0.685) than TyG or ABSI alone (TyG: 0.661; ABSI: 0.608; DeLong test p < 0.001). CONCLUSION: The joint elevation of TyG and ABSI identifies individuals with prediabetes at higher CVD risk independent of conventional indicators, especially within hypertensive subgroups, enabling targeted monitoring and intervention to alleviate the CVD burden.