Zhang Mingzhu, Guan Qihua, Guo Zheng, Guan Chaoqun, Jin Xiangqian, Dong Hualei, Tang Shaocan, Hou Haifeng
School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Epidemiology Center, Nashville, TN USA.
EPMA J. 2024 Oct 8;15(4):611-627. doi: 10.1007/s13167-024-00380-6. eCollection 2024 Dec.
Hypertension is a major modifiable cause of cardiovascular diseases and premature death worldwide. The triglyceride-glucose-body mass index (TyG-BMI), as a novel indicator, has been proposed for assessing hypertension risk. Nevertheless, a paucity of studies has explored the predictive potential of dynamic TyG-BMI for hypertension. The purpose of this study was to investigate whether cumulative TyG-BMI could better predict hypertension incidence and explore the interplay between TyG and BMI in hypertension development. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that dynamic monitoring of TyG-BMI level and joint assessment of TyG and BMI provide novel insights for individual risk assessment, targeted prevention, and personalized intervention of cardiovascular diseases.
Using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide cohort conducted between 2011 and 2018, the changes in TyG-BMI between 2012 and 2015 were categorized into four groups by -means clustering analysis. Cumulative TyG-BMI was also divided into four levels based on quartile cutoffs. Logistic regression and restricted cubic spline analyses were performed to examine the associations of different TyG-BMI classes with hypertension. Mediating and interactive analyses were utilized to discern the mutual effects between TyG and BMI in hypertension development.
A total of 2891 participants were enrolled, among whom 386 (13.4%) developed hypertension during a median 36.5-month follow-up period. Logistic regression analysis revealed that, compared to participants with persistently low TyG‑BMI, an increased risk of hypertension was observed among those with a moderate (odds ratio (OR) = 1.60, 95% confidence interval (CI) 1.15 to 2.22), a higher (OR = 1.93, 95% CI 1.28 to 2.89), and the highest TyG‑BMI (OR = 2.33, 95% CI 1.35 to 4.03). A positive linear association of cumulative TyG-BMI with hypertension was discovered ( for non-linear = 0.343). Furthermore, TyG partially mediated the relationship between BMI and hypertension, accounting for 13.18% of the total effect. The joint effect of BMI and TyG was positively affiliated to hypertension development.
This study demonstrated a significant positive association between dynamic TyG-BMI and hypertension among the Chinese middle-aged and older population. In the context of PPPM/3PM, long-term monitoring of TyG-BMI could assist in identifying individuals at high risk of hypertension, strengthening primary prevention efforts and facilitating prompt intervention strategies. In addition, this study revealed the mutual effect of TyG and BMI on hypertension development, which provides a novel approach for mitigating the risk of cardiovascular diseases via addressing metabolic disorders, thereby enhancing effective prevention and targeted intervention.
The online version contains supplementary material available at 10.1007/s13167-024-00380-6.
高血压是全球心血管疾病和过早死亡的主要可改变病因。甘油三酯-血糖-体重指数（TyG-BMI）作为一种新指标，已被提出用于评估高血压风险。然而，很少有研究探讨动态TyG-BMI对高血压的预测潜力。本研究的目的是调查累积TyG-BMI是否能更好地预测高血压发病率，并探讨TyG与BMI在高血压发生过程中的相互作用。从预测、预防和个性化医学（PPPM/3PM）的角度来看，我们假设对TyG-BMI水平进行动态监测以及对TyG和BMI进行联合评估可为心血管疾病的个体风险评估、针对性预防和个性化干预提供新的见解。
利用中国健康与养老追踪调查（CHARLS）的数据，该调查是一项在2011年至2018年期间进行的全国性队列研究，通过均值聚类分析将2012年至2015年期间TyG-BMI的变化分为四组。累积TyG-BMI也根据四分位数切点分为四个水平。进行逻辑回归和限制立方样条分析以检验不同TyG-BMI类别与高血压之间的关联。利用中介分析和交互分析来识别TyG与BMI在高血压发生过程中的相互作用。
共纳入2891名参与者，其中386名（13.4%）在中位36.5个月的随访期内发生高血压。逻辑回归分析显示，与TyG-BMI持续较低的参与者相比，TyG-BMI为中度（比值比（OR）=1.60，95%置信区间（CI）1.15至2.22）、较高（OR=1.93，95%CI 1.28至2.89）和最高（OR=2.33，95%CI 1.35至4.03）的参与者患高血压的风险增加。发现累积TyG-BMI与高血压呈正线性关联（非线性时为0.343）。此外，TyG部分介导了BMI与高血压之间的关系，占总效应的13.18%。BMI和TyG的联合效应与高血压发生呈正相关。
本研究表明，在中国中老年人群中，动态TyG-BMI与高血压之间存在显著正相关。在PPPM/3PM的背景下，对TyG-BMI进行长期监测有助于识别高血压高危个体，加强一级预防工作并促进及时干预策略。此外，本研究揭示了TyG与BMI对高血压发生的相互作用，这为通过解决代谢紊乱来降低心血管疾病风险提供了一种新方法，从而加强有效预防和针对性干预。
在线版本包含可在10.1007/s13167-024-00380-6获取的补充材料。
