Central adiposity is associated with incident infective endocarditis

Central adiposity and metabolic dysfunction are associated with adverse cardiovascular outcomes, but their associations with incident infective endocarditis (IE) remain unclear. We compared conventional anthropometric and TyG-based indices in relation to incident IE in UK Biobank participants. We analysed 386,859 participants recruited between 2006 and 2010. A 2-year landmark design was applied. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), the triglyceride-glucose (TyG) index, and TyG-based composite indices were assessed. Cox proportional-hazards models with multiple imputation estimated associations with incident IE. Cubic spline, competing-risk, and additional sensitivity analyses evaluated dose–response patterns and robustness. Over 5.55 million person-years of follow-up (median, 14.88 years), 1,124 participants developed incident IE, corresponding to an incidence rate of 20.24 per 100,000 person-years. In the primary adjusted model, each standard-deviation increase in WC and WHtR was associated with incident IE, with HRs of 1.31 (95% CI, 1.23–1.40) and 1.29 (95% CI, 1.22–1.37), respectively. BMI and TyG-based composite indices were also positively associated with incident IE, whereas the association for TyG alone was more modest. WC and WHtR showed positive dose–response associations with incident IE. Higher central adiposity, assessed by WC and WHtR, was consistently associated with a higher long-term hazard of incident IE.