TyG-ABSI mediates the association between Naples Prognostic Score and cataract in US adults

The Naples Prognostic Score (NPS), a comprehensive indicator of inflammation and nutrition, remains unstudied in relation to cataract prevalence. We analyzed 8612 adults (≥20 years) from the National Health and Nutrition Examination Survey (NHANES) 1999–2008 in this cross-sectional study. Each 1-point increase in NPS was associated with 25% higher odds of cataract, and high NPS participants had 80% higher odds than low NPS. Restricted cubic spline (RCS) analysis indicated a significant linear association. Subgroup analysis strengthens the positive correlation between NPS and cataracts. Exploratory mediation analysis suggested that the triglyceride-glucose index-based A Body Shape Index (TyG-ABSI) may partially explain this association, particularly among nondiabetic individuals. These findings indicate that high NPS is independently and linearly associated with increased cataract prevalence in US adults, and exploratory analyses suggest that TyG-ABSI may partially mediate this association. These results support the potential benefit of maintaining optimal NPS values in mitigating cataract development.