美国非肥胖成年人（1999 - 2020年国家健康与营养检查调查）中新型甘油三酯及甘油三酯-葡萄糖衍生肥胖指数与高血压的关联

Associations of Novel Triglyceride- and Triglyceride-Glucose-Derived Obesity Indices with Hypertension in Nonobese US Adults (NHANES 1999--2020).

作者信息

Chen Lingling, Yin Lixue

机构信息

Department of Cardiovascular Ultrasound & Noninvasive Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Ultrasound Medicine and Computational Cardiology Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Am J Hypertens. 2025 Aug 1. doi: 10.1093/ajh/hpaf146.

DOI:10.1093/ajh/hpaf146

PMID:40747643

Abstract

BACKGROUND

Visceral obesity, insulin resistance (IR), and glycolipid abnormalities are associated with an increased risk of hypertension (HTN). The study aimed to explore the correlation between novel triglyceride- and triglyceride‒glucose-derived obesity indices associated with these hypertension risk factors, and the prevalence of HTN among nonobese adults.

METHODS

We extracted data from 12,717 nonobese adults from NHANES between 1999-2020 and calculated triglyceride-derived obesity indices (lipid accumulation product (LAP), visceral adiposity index (VAI), and cardiometabolic index (CMI)), triglyceride-glucose-derived obesity indices (triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR)) and traditional anthropometric indices. Logistic regression, curve fitting and subgroup analyses were employed to investigate the associations between these novel obesity indices and HTN prevalence. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive accuracy of all the above obesity parameters.

RESULTS

After weighted analysis of the data, the results of this study represented approximately 119.00 million nonobese U.S. adults. The prevalence of HTN was 49.74% (men 53.45%). The multivariate logistic regression analysis revealed that LAP, VAI, CMI, TyG-BMI, TyG-WC and TyG-WHtR were significantly associated with HTN. Smoothed curve-fitting analysis revealed that the LAP, VAI and CMI correlated nonlinearly with HTN.The area under the curve (AUC) for HTN was greater for all novel obesity indices compared to commonly used traditional anthropometric parameters such as BMI, WC, and WHtR.

CONCLUSIONS

LAP, VAI, CMI, TyG-BMI, TyG-WC, and TyG-WHtR were significantly associated with HTN and demonstrated potentially better predictive capability than commonly used traditional anthropometric measures.

摘要

背景

内脏肥胖、胰岛素抵抗（IR）和糖脂异常与高血压（HTN）风险增加相关。本研究旨在探讨与这些高血压风险因素相关的新型甘油三酯和甘油三酯 - 葡萄糖衍生肥胖指数与非肥胖成年人中高血压患病率之间的相关性。

方法

我们从1999 - 2020年美国国家健康与营养检查调查（NHANES）的12717名非肥胖成年人中提取数据，计算甘油三酯衍生肥胖指数（脂质积聚产物（LAP）、内脏脂肪指数（VAI）和心脏代谢指数（CMI））以及甘油三酯 - 葡萄糖衍生肥胖指数（甘油三酯葡萄糖 - 体重指数（TyG - BMI）、甘油三酯葡萄糖 - 腰围（TyG - WC）和甘油三酯葡萄糖 - 腰高比（TyG - WHtR））和传统人体测量指数。采用逻辑回归、曲线拟合和亚组分析来研究这些新型肥胖指数与高血压患病率之间的关联。进行受试者操作特征（ROC）曲线分析以评估上述所有肥胖参数的预测准确性。

结果

对数据进行加权分析后，本研究结果代表了约1.19亿非肥胖美国成年人。高血压患病率为49.74%（男性为53.45%）。多因素逻辑回归分析显示，LAP、VAI、CMI、TyG - BMI、TyG - WC和TyG - WHtR与高血压显著相关。平滑曲线拟合分析显示，LAP、VAI和CMI与高血压呈非线性相关。与常用的传统人体测量参数如BMI、WC和WHtR相比，所有新型肥胖指数预测高血压的曲线下面积（AUC）更大。