Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China.
Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China.
Nutr Metab Cardiovasc Dis. 2024 Sep;34(9):2134-2142. doi: 10.1016/j.numecd.2024.05.014. Epub 2024 May 18.
Insulin resistance (IR) has previously been associated with hypertension, and obesity is a risk factor for IR and hypertension. There is likely an association between body mass index (BMI) and risk for hypertension through the triglyceride-glucose (TyG) index but this relationship remains uncharacterized.
This study is based on the Hanzhong Adolescent Hypertension Cohort, which is an ongoing prospective study established in 1987. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/]. The total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trend of BMI, respectively. We found that BMI AUCt and BMI AUCi were significantly associated with the risk of adult hypertension, both without (RR = 1.30/1.31 for BMI AUCt/AUCi) and with (RR = 1.25/1.26 for BMI AUCt/AUCi) the inclusion of the TyG index as a covariate. Importantly, mediation analysis revealed that the TyG index mediated the BMI AUCt-SBP association (19.3%), the BMI AUCt-DBP association (22.7%), the BMI AUCi-SBP association (18.5%) and the BMI AUCi-DBP association (21.3%). Furthermore, the TyG index had a significant mediating effect of 15.9% on the BMI AUCt-hypertension association and 14.9% on the BMI AUCi-hypertension association.
These findings suggest that the TyG index plays an important mediating role in the association between the cumulative burden and increasing trends of BMI originating in childhood and the risk of hypertension in midlife. We emphasize that early weight management has the potential to reduce the burden of hypertension caused by IR.
The study was clinically registered at the ClinicalTrials.gov (NCT02734472) and approved by the Academic Committee of the First Affiliated Hospital of Xi'an Jiaotong University (XJTU1AF2015LSL-047).
胰岛素抵抗（IR）先前与高血压相关，肥胖是 IR 和高血压的危险因素。通过三酰甘油-葡萄糖（TyG）指数，体重指数（BMI）与高血压风险之间可能存在关联，但这种关系尚未明确。
本研究基于汉中青少年高血压队列，这是一个始于 1987 年的正在进行的前瞻性研究。TyG 指数的计算方法为 ln[空腹三酰甘油(mg/dl)×空腹血糖(mg/dl)/]。总曲线下面积（AUCt）和增量 AUC（AUCi）分别计算为 BMI 的长期负担和趋势。我们发现，BMI AUCt 和 BMI AUCi 与成人高血压风险显著相关，且均无（RR=1.30/1.31，BMI AUCt/AUCi）和有（RR=1.25/1.26，BMI AUCt/AUCi）纳入 TyG 指数作为协变量。重要的是，中介分析表明，TyG 指数介导了 BMI AUCt-SBP 关联（19.3%）、BMI AUCt-DBP 关联（22.7%）、BMI AUCi-SBP 关联（18.5%）和 BMI AUCi-DBP 关联（21.3%）。此外，TyG 指数对 BMI AUCt-高血压关联的中介作用有显著影响（15.9%），对 BMI AUCi-高血压关联的中介作用为 14.9%。
这些发现表明，TyG 指数在儿童期 BMI 累积负担和增加趋势与中年高血压风险之间的关联中发挥重要的中介作用。我们强调，早期体重管理有可能降低由 IR 引起的高血压负担。
该研究在 ClinicalTrials.gov 上进行了临床注册（NCT02734472），并获得了西安交通大学第一附属医院学术委员会的批准（XJTU1AF2015LSL-047）。
