Zhu Haiyuan, Zhang Zebang, Feng Yumei, Wu Qiqi, Zhang Runquan, Liu Tao, Liu Dan, Chen Xiongfei, Dong Xiaomei
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China.
Nutrients. 2025 Aug 27;17(17):2783. doi: 10.3390/nu17172783.
The global prevalence of pediatric hypertension is on the rise. Adolescence is a period of high prevalence of childhood hypertension. Obesity and insulin resistance (IR) are important risk factors in the development of hypertension, but their interaction and combined effects on adolescent hypertension remain unclear. This cross-sectional study utilized data from the China National Nutrition and Health Surveillance of Children and Lactating Mothers (2016-2017). A total of 7031 adolescents aged 12-17 years from five provinces were included. The triglyceride-glucose index (TyG) was used as an indicator of IR. Multivariable logistic regression and generalized linear mixed-effect models were used to assess the interaction and joint effects of IR and obesity (measured by body mass index [BMI] and waist circumference [WC]) on hypertension. Relative excess risk due to interaction (RERI), proportion attributable to interaction (AP), and synergy index (SI) were calculated to evaluate additive interactive effects. Mediation analysis explored the potential mediating role of the TyG in the association between obesity and hypertension. IR and obesity were positively associated with adolescent hypertension ( < 0.001). Interaction analyses revealed a robust synergistic interaction between obesity and IR on hypertension, with the AP being approximately 40% ( < 0.001). TyG significantly mediated the association between obesity and adolescent hypertension (6.30% for high BMI and 8.54% for high WC, both < 0.001). This study suggests that obesity and IR could synergistically contribute to the prevalence of hypertension in adolescents. For the primary prevention and management of hypertension in adolescents, strategies targeting both factors should be considered.
儿童高血压的全球患病率正在上升。青春期是儿童高血压的高发期。肥胖和胰岛素抵抗（IR）是高血压发展的重要危险因素，但其对青少年高血压的相互作用和综合影响仍不清楚。这项横断面研究利用了中国儿童和哺乳期母亲营养与健康监测（2016 - 2017年）的数据。共纳入了来自五个省份的7031名12至17岁的青少年。甘油三酯 - 葡萄糖指数（TyG）被用作胰岛素抵抗的指标。采用多变量逻辑回归和广义线性混合效应模型来评估胰岛素抵抗和肥胖（通过体重指数[BMI]和腰围[WC]衡量）对高血压的相互作用和联合效应。计算交互作用导致的相对超额危险度（RERI）、交互作用归因比例（AP）和协同指数（SI）以评估相加交互作用效应。中介分析探讨了TyG在肥胖与高血压关联中的潜在中介作用。胰岛素抵抗和肥胖与青少年高血压呈正相关（<0.001）。交互作用分析显示肥胖和胰岛素抵抗在高血压方面存在强大的协同交互作用，交互作用归因比例约为40%（<0.001）。TyG显著介导了肥胖与青少年高血压之间的关联（高BMI时为6.30%，高WC时为8.54%，均<0.001）。本研究表明，肥胖和胰岛素抵抗可能协同导致青少年高血压的患病率上升。对于青少年高血压的一级预防和管理，应考虑针对这两个因素的策略。
