Associations of the triglyceride-glucose index and its obesity-related derivatives with cardiac structure, function, and incident atrial fibrillation: a prospective cohort study using cardiac magnetic resonance

TyG obesity-related derivatives, particularly TyG-WC, were independently associated with incident AF. Cardiac structural remodeling, especially LA enlargement, appeared to be a key mediating pathway. These findings support the importance of early metabolic intervention to prevent adverse atrial remodeling and reduce AF susceptibility.