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非杓型高血压与甘油三酯葡萄糖指数的关系。

The relationship between nondipper hypertension and triglyceride glucose index.

机构信息

Department of Cardiology, Faculty of Medicine Recep Tayyip Erdoğan University, Rize.

Department of Cardiology, Faculty of Medicine, Namik Kemal University, Tekirdağ, Turkey.

出版信息

Blood Press Monit. 2022 Dec 1;27(6):384-390. doi: 10.1097/MBP.0000000000000618. Epub 2022 Sep 12.

Abstract

Nondipper hypertensive patients have an increased incidence of damage to end organs, including the brain, heart, and kidney, and a worse cardiovascular prognosis. The triglyceride glucose (TyG) index is a reliable indicator of insulin resistance (IR) and is closely related to the traditional risk factors of cardiovascular disease. To the best of our knowledge, whether there is a relationship between the TyG index and impaired diurnal blood pressure (BP) has not been investigated. This study aimed to compare the TyG index between normotensive, nondipper, and dipper hypertensive patients. A total of 1037 patients grouped according to the results of ambulatory BP monitoring were included, with group 1 including dipper hypertensive ( n = 368), group 2 including nondipper hypertensive ( n = 496), and group 3 including normotensive control ( n = 173) patients. In both the univariate and multivariate logistic regression analyses, TyG index [odds ratio (OR), 4.656; 95% confidence interval (CI), 3.014-7.193; P < 0.001], age (OR, 1.011; 95% CI, 1.002-1.021; P = 0.018), and glomerular filtration rate (GFR) (OR, 0.979; 95% CI, 0.971-0.987; P < 0.001) were independent predictors of nondipper hypertension (HT). In the ROC analysis, a TyG index cutoff value of at least 4.74 predicted nondipper hypertensive patients with a sensitivity of 59.7%, and a specificity of 59.9% [area under the curve = 0.647 (0.614-0.680); 95% CI; P < 0.001]. We showed that TyG index, age, and GFR are independent predictors in patients with nondipper HT. TyG index, a simple, cost-effective, and rapid tool can predict the nondipper pattern in essential HT.

摘要

非杓型高血压患者终末器官损害的发生率增加,包括脑、心和肾,心血管预后更差。甘油三酯-葡萄糖(TyG)指数是胰岛素抵抗(IR)的可靠指标,与心血管疾病的传统危险因素密切相关。据我们所知,TyG 指数与日间血压(BP)受损之间是否存在关系尚未得到研究。本研究旨在比较正常血压、非杓型和杓型高血压患者的 TyG 指数。根据动态血压监测结果将 1037 例患者分为三组,第 1 组为杓型高血压(n=368),第 2 组为非杓型高血压(n=496),第 3 组为正常血压对照组(n=173)。在单因素和多因素 logistic 回归分析中,TyG 指数[比值比(OR),4.656;95%置信区间(CI),3.014-7.193;P<0.001]、年龄(OR,1.011;95%CI,1.002-1.021;P=0.018)和肾小球滤过率(GFR)(OR,0.979;95%CI,0.971-0.987;P<0.001)是非杓型高血压(HT)的独立预测因素。在 ROC 分析中,TyG 指数至少为 4.74 预测非杓型高血压患者的敏感性为 59.7%,特异性为 59.9%[曲线下面积=0.647(0.614-0.680);95%CI;P<0.001]。我们表明,TyG 指数、年龄和 GFR 是非杓型 HT 患者的独立预测因素。TyG 指数是一种简单、经济有效的快速工具,可预测原发性 HT 中的非杓型模式。

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