Wang Mengmeng, Teng Tianqi, Zhang Nan, Xu Jiachao, Dong Zihan, Jiao Qingying, Zhang Ning, Yu Haichu
Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Cardiovasc Diabetol. 2025 Jul 11;24(1):284. doi: 10.1186/s12933-025-02813-6.
The direct association between elevated levels of the triglyceride-glucose index (TyG index) and its derived metrics and the risk of new-onset hypertension in prehypertensive populations remains unclear. The study systematically evaluated the link between the TyG index and its related indicators with new-onset hypertension by integrating cohort study methods with Mendelian randomization (MR) analysis.
A total of 2,815 prehypertensive participants from the 2011 CHARLS database were included, of whom 877 (31.15%) progressed to new-onset hypertension by 2015. TyG-Waist-to-Height Ratio (TyG-WHtR), TyG-Body Mass Index (TyG-BMI), TyG-Waist Circumference (TyG-WC), and the TyG index were calculated. Logistic regression, restricted cubic spline (RCS) curves, subgroup analyses, and interaction tests were performed to assess the associations. Bayesian weighted MR (BWMR) was further used to validate causal relationships.
Multivariable regression analysis revealed that each unit increase in the TyG index was associated with a 45% higher risk of new-onset hypertension (odds ratio [OR]: 1.45, 95% confidence intervals [CI] 1.24-1.70, P < 0.001), while TyG-WHtR showed a 42% increased risk (OR: 1.42, 95% CI 1.26-1.60, P < 0.001). Categorizing the TyG and its derived metrics by quartiles demonstrated that higher quartiles (Q3 and Q4) were significantly linked to an elevated risk of new-onset hypertension across all models (P < 0.001). RCS models indicated significant positive linear relationships between the TyG index and TyG-WC with new-onset hypertension (P for overall < 0.001, P for nonlinearity = 0.844 and 0.165, respectively), whereas TyG-WHtR and TyG-BMI exhibited significant positive nonlinear relationships (P for overall < 0.001, P for nonlinearity = 0.001 and 0.046, respectively). Subgroup analyses highlighted stronger associations among individuals aged ≥ 70 years, those who were widowed, had cardiovascular disease, or reported a life satisfaction score of 2 (P < 0.05, P for interaction < 0.05). BWMR analysis confirmed a significant causal relationship between genetically elevated TyG index levels and an increased risk of new-onset hypertension (P < 0.05).
Our study reveals a significant link between the TyG index and its related indicators with new-onset hypertension in prehypertensive populations. Causal analysis using BWMR confirmed that genetically elevated TyG index levels increase the risk of new-onset hypertension. These results highlight the importance of monitoring TyG-related indices for early detection and intervention in high-risk individuals, aiding in the prevention of hypertension progression.
甘油三酯-葡萄糖指数（TyG指数）及其衍生指标水平升高与高血压前期人群新发高血压风险之间的直接关联尚不清楚。本研究通过整合队列研究方法和孟德尔随机化（MR）分析，系统评估了TyG指数及其相关指标与新发高血压之间的联系。
纳入了2011年中国健康与养老追踪调查（CHARLS）数据库中的2815名高血压前期参与者，其中877名（31.15%）到2015年进展为新发高血压。计算了TyG-腰高比（TyG-WHtR）、TyG-体重指数（TyG-BMI）、TyG-腰围（TyG-WC）和TyG指数。进行了逻辑回归、限制性立方样条（RCS）曲线分析、亚组分析和交互作用检验以评估相关性。进一步采用贝叶斯加权MR（BWMR）来验证因果关系。
多变量回归分析显示，TyG指数每增加一个单位，新发高血压风险增加45%（比值比[OR]：1.45，95%置信区间[CI] 1.24-1.70，P < 0.001），而TyG-WHtR显示风险增加42%（OR：1.42，95% CI 1.26-1.60，P < 0.001）。按四分位数对TyG及其衍生指标进行分类表明，在所有模型中，较高的四分位数（Q3和Q4）与新发高血压风险升高显著相关（P < 0.001）。RCS模型表明，TyG指数和TyG-WC与新发高血压之间存在显著的正线性关系（总体P < 0.001，非线性P分别为0.844和0.165），而TyG-WHtR和TyG-BMI表现出显著的正非线性关系（总体P < 0.001，非线性P分别为0.001和0.046）。亚组分析突出了年龄≥70岁、丧偶、患有心血管疾病或生活满意度评分为2的个体之间更强的关联（P < 0.05，交互作用P < 0.05）。BWMR分析证实，基因水平升高的TyG指数与新发高血压风险增加之间存在显著的因果关系（P < 0.05）。
我们的研究揭示了高血压前期人群中TyG指数及其相关指标与新发高血压之间的显著联系。使用BWMR进行的因果分析证实，基因水平升高的TyG指数会增加新发高血压的风险。这些结果突出了监测TyG相关指标对于高危个体早期检测和干预的重要性，有助于预防高血压进展。
