Association between triglyceride-glucose index-a body shape index and atherosclerotic cardiovascular disease, and the modification effect of dietary patterns

Background The association of the triglyceride-glucose index-a body shape index (TyG-ABSI), a novel indicator integrating glucose and lipid metabolism with obesity status, with atherosclerotic cardiovascular disease (ASCVD), and the underlying mechanisms, have not been elucidated. Methods We conducted a retrospective cross-sectional study using data from the health examination center of Nanchang University Second Affiliated Hospital. The multivariable logistic regression models, restricted cubic spline (RCS) regression models, receiver operating characteristic (ROC) curve analysis, subgroup analyses, mediation analyses, and sensitivity analyses were used to evaluate the potential relationship and explore potential mechanisms between TyG-ABSI and ASCVD. Results Individual TyG and ABSI were both positively associated with ASCVD, and TyG and ABSI had a significantly synergistic effect on ASCVD. Furthermore, TyG-ABSI was significantly linear and positively associated with ASCVD. In the fully adjusted model, each unit increment in TyG-ABSI was associated with a 152.2% higher odds ratio of ASCVD (OR = 2.522, 95% CI: 1.388–4.054). This positive association was robust in most subgroups. In addition, TyG-ABSI presented better diagnostic performance for ASCVD diagnosis compared with TyG, ABSI, TyG-BMI, TyG-WC, and TyG-MHtR. In addition, inflammation-related indicators (CRP, SIRI, MLR, and NLR) and the oxidative stress-related indices (GGT, UA) had significant mediation effects on the association between TyG-ABSI and ASCVD. Some dietary patterns, such as aMed, HEI-2020, DASH, may have modifying effects on the association. Conclusions This study elucidates the significant positive dose-response linear relationship of TyG-ABSI with ASCVD, the moderately diagnostic performance of TyG-ABSI for ASCVD, and the mediation effects of CRP, SIRI, MLR, NLR, GGT, and UA. However, these inflammation and oxidative indicators should be viewed strictly as exploratory and hypothesis-generating for a mediating role, due to our cross-sectional design. Dietary patterns, such as aMed, HEI-2020, DASH, may have modifying effects on the association.