Abstract
This study aimed to examine the association between the triglyceride-glucose (TyG) index, TyG-BMI index, and gallbladder disease (GBD) among Uyghurs in the Xinjiang Production and Construction Corps (XPCC), offering insights for GBD prevention and management. A prospective cohort design was utilized, enrolling 12,794 Uyghur participants from XPCC. The cumulative GBD incidence across quartiles of TyG, TyG-BMI, and BMI categories was estimated using the Kaplan-Meier method. The Cox proportional hazard regression model assessed the association between TyG, TyG-BMI, and GBD incidence, while mediation analysis investigated TyG's potential mediating role in the relationship between BMI and GBD. Participants had a mean age of 37.68 ± 13.96 years, with 51.30% being male. Over a median follow-up of 6.00 years, 466 new GBD cases were identified, yielding a cumulative incidence of 4.3% and an incidence density of 7.68 per 1000 person-years. Women exhibited a higher cumulative incidence of GBD than men. The incidence of GBD gradually rises in both men and women with the increase of age. When the age exceeds 40, the incidence of GBD increases significantly. Following adjustments for gender, age, educational level, exercise frequency, diabetes, HDL-C, and LDL-C levels, individuals in the Q4 TyG index group demonstrated a significantly elevated GBD risk relative to the Q1 group (HR = 1.34, 95% CI:1.01-1.77). Similarly, GBD risk rose progressively across the Q2, Q3, and Q4 TyG-BMI index groups (HR = 1.97, 95% CI:1.23-3.16), (HR = 2.67, 95% CI:1.70-4.19), and (HR = 4.47, 95% CI:2.88-6.93), respectively. Overweight and obesity were also linked to a markedly greater GBD risk compared to normal weight (HR = 1.52, 95% CI:1.09-2.12) and (HR = 3.01, 95% CI:2.22-4.09). Among Uyghurs in the XPCC, elevated TyG and TyG-BMI indices were strongly associated with GBD risk, with TyG-BMI demonstrating the most pronounced association. Early TyG-BMI monitoring may aid in identifying individuals at high risk of developing GBD.