Abstract
BackgroundInsulin resistance (IR)-related indices and moderate-to-vigorous physical activity (MVPA) were independent predictors for cardiometabolic disease (CMD) and multimorbidity (CMM), but their combined effect is unclear. We aimed to investigate their joint effect on incident CMD and CMM.MethodsThis study was conducted from the UK Biobank accelerometer sub-study. The IR-related indices included triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and metabolic score for IR (Mets-IR). Participants were divided according to the median values of IR-related indices and MVPA time. Cox regression was used to assess the associations between different groups and outcomes, with interaction effects estimated.Results74,367 participants were included. Compared to participants with low TyG index and high MVPA, the adjusted HR (aHR) for CMD was 1.71 (95% CI: 1.55-1.88) for high TyG and low MVPA. The corresponding aHR were 1.82 (95%CI: 1.66-1.99) for TyG-BMI, 1.96 (95%CI: 1.77-2.17) for TyG-WC, 1.88 (95%CI: 1.71-2.07) for TyG-WHtR, and 1.90 (95%CI: 1.73-2.09) for Mets-IR, with significant additive interactions. Similar associations were observed in incident CMM.ConclusionsIR-related indices and MVPA had synergistic effects in incident CMD and CMM, highlighting the importance of identification and prevention for CMD and CMM.Graphical Abstract# Adjusted for age, sex, ethnicity, smoking status, healthy diet score, alcohol frequency, Townsend deprivation index, employment status, income level, education, systolic blood pressure, glycated hemoglobin, high-sensitivity C-reactive protein, and estimated glomerular filtration rate; * P value <0.05.