Figure 3

Mediation analysis of TyG index as mediators of the association between BMI and left cardiac function. Values adjacent to the arrows depict β-coefficients (95% CIs) and P values from linear regression models adjusted for age, sex, smoking status, alcohol use, hypertension and T2DM. The total effect of the association of BMI with outcomes (left cardiac function) on linear regression analysis is a prerequisite for mediation analysis. (a) Investigates the assumptions that BMI is associated with increased mediators (TyG index) and that mediators are associated with increased/decreased outcomes (LA function, LACI, LV function). Outcomes in light purple do not fulfill the assumptions for mediation analysis because there is no statistically significant effect between mediator and outcome. (b) Mediated effect in mediation analysis of parameters indicating that 25.2–25.6% of the association of BMI with decreased LA function is mediated by TyG index. Percent mediated = mediated effect/total effect × 100. Beta coefficients reflect the change in the dependent variable per 1 kg/m2 increase in BMI. Abbreviations as in Figs. 1, 2.