ArticleCardiovascular diabetology. Endocrinology reports2026
The combined predictive value of the triglyceride-glucose index and A Body Shape Index on all-cause mortality: a 26-year prospective cohort analysis from the Rancho Bernardo Study.
Article in Cardiovascular diabetology. Endocrinology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInsulin resistance, represented by the triglyceride-glucose (TyG) index, shows interplay with visceral obesity and together promotes cardiovascular diseases and mortality. Recent NHANES data demonstrated that combining TyG with A Body Shape Index (ABSI) outperforms traditional TyG-derived indices in predicting cardiovascular mortality. However, validation in independent cohorts with extended follow-up is needed.
methodsWe analyzed 1,753 participants from Visit 7 of the Rancho Bernardo Study (1988–1992). TyG was calculated as ln[(triglycerides × glucose)/2], ABSI as WC/(BMI2/3 × height1/2), and TyG-ABSI as their product. Cox proportional hazards models assessed associations with all-cause mortality. Harrell’s C-index compared predictive performance, integrated discrimination improvement (IDI), and net reclassification improvement (NRI).
resultsDuring median follow-up of 26.3 years (maximum 31 years), 1,166 deaths occurred (66.5% mortality rate) with zero participants lost to follow-up. The highest TyG-ABSI quartile had significantly increased mortality versus the lowest (fully-adjusted HR = 1.68, 95% CI 1.40–2.02, p < 0.001). TyG-ABSI demonstrated superior C-index (0.710) versus TyG alone (0.623, p < 0.001), with significant IDI (0.032, p < 0.001) and NRI (0.156, p < 0.001). Restricted cubic spline analysis revealed a linear dose-response relationship (p for non-linearity = 0.184). Association was particularly strong in younger adults (< 60 years: HR = 2.74, 95% CI 1.71–4.38, p < 0.001; p-interaction < 0.001).
conclusionsTyG-ABSI demonstrated superior predictive value for all-cause mortality compared to TyG alone and other modified TyG indices. The particularly strong association in younger adults suggests TyG-ABSI may be especially valuable for early risk stratification.
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