甘油三酯-葡萄糖指数轨迹与高血压相关：一项回顾性纵向队列研究。

The triglyceride glucose index trajectory is associated with hypertension: a retrospective longitudinal cohort study.

机构信息

School of Public Health, Dalian Medical University, No.9, West Section of Lushunkou Road, Lushunkou District, Dalian, Liaoning, 116000, China.

Dalian Neusoft Institute of Information, No.8, Software Park Road, Ganjingzi District, Dalian, Liaoning, 116000, China.

出版信息

Cardiovasc Diabetol. 2023 Dec 15;22(1):347. doi: 10.1186/s12933-023-02087-w.

DOI:10.1186/s12933-023-02087-w

PMID:38102704

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10725029/

Abstract

BACKGROUND

Previous studies have found that the triglyceride glucose index (TyG index) trajectories are associated with cardiovascular diseases. However, the association between the patterns of TyG index trajectories and risk for hypertension has not been investigated. In a longitudinal general population, we aimed to identify distinct TyG index trajectories over 12 years and describe their association with incidence of hypertension.

METHOD

Of the 15,056 adults retrospectively recruited from the Physical Examination Center of the Second Affiliated Hospital of Dalian Medical University in northeast of China from 2011 to 2022. TyG index was calculated as ln (fasting TG [mg/dL] × FPG [mg/dL]/2) and the TyG index trajectories were developed using group-based trajectory modelling. Cox regression analysis was accomplished to assess the association between TyG index and incidence of hypertension.

RESULTS

The median age of the population was 38 years, and 7352 (48.83%) of the participants were men. Three distinct TyG index trajectories were identified: "low increasing" (N = 7241), "moderate increasing" (N = 6448), and "high stable" (N = 1367). Using "low increasing" trajectory as a reference, "moderate increasing" and "high stable" trajectory were associated with increased risk of hypertension (HR = 2.45; 95% CI 2.25-2.67 and HR = 3.88; 95% CI 3.48-4.33). After adjusting for baseline sex, age, diabetes, smoking, systolic blood pressure, diastolic blood pressure, BMI, cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, blood glucose, triglyceride, urea, uric acid, and glomerular filtration rate, the HR were slightly attenuate in "moderate increasing" and "high stable" trajectories to 1.38 (95% CI 1.23-1.54) and 1.69 (95% CI 1.40-2.02) respectively. Meanwhile, similar results were observed in multiple sensitivity analyses. The HR of the "moderate increasing" and "high stable" trajectory groups were 2.63 (95% CI 2.30-3.00) and 4.66 (95% CI 3.66-5.93) in female, and 1.66 (95% CI 1.48-1.86) and 2.33 (95% CI 2.04-2.66) in male.

CONCLUSIONS

Elevated TyG index at baseline and long-term TyG index trajectories were associated with the risk of hypertension. Early identification of increasing TyG index could provide insights for preventing hypertension later in life.

摘要

背景

先前的研究发现，甘油三酯-葡萄糖指数（TyG 指数）轨迹与心血管疾病有关。然而，TyG 指数轨迹的模式与高血压风险之间的关联尚未得到研究。在一项纵向的一般人群中，我们旨在确定 12 年内不同的 TyG 指数轨迹，并描述它们与高血压发病的关系。

方法

我们从中国东北部大连医科大学第二附属医院体检中心回顾性招募了 2011 年至 2022 年的 15056 名成年人。TyG 指数计算为 ln（空腹 TG[mg/dL]×FPG[mg/dL]/2），并使用基于群组的轨迹建模来开发 TyG 指数轨迹。Cox 回归分析用于评估 TyG 指数与高血压发病之间的关联。

结果

该人群的中位年龄为 38 岁，其中 7352 名（48.83%）参与者为男性。确定了三种不同的 TyG 指数轨迹：“低升高”（N=7241）、“中升高”（N=6448）和“高稳定”（N=1367）。以“低升高”轨迹为参照，“中升高”和“高稳定”轨迹与高血压发病风险增加相关（HR=2.45；95%CI 2.25-2.67 和 HR=3.88；95%CI 3.48-4.33）。在校正基线性别、年龄、糖尿病、吸烟、收缩压、舒张压、BMI、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血糖、甘油三酯、尿素、尿酸和肾小球滤过率后，“中升高”和“高稳定”轨迹的 HR 略有减弱，分别为 1.38（95%CI 1.23-1.54）和 1.69（95%CI 1.40-2.02）。同时，在多项敏感性分析中也观察到了类似的结果。在女性中，“中升高”和“高稳定”轨迹组的 HR 分别为 2.63（95%CI 2.30-3.00）和 4.66（95%CI 3.66-5.93），在男性中，HR 分别为 1.66（95%CI 1.48-1.86）和 2.33（95%CI 2.04-2.66）。