使用甘油三酯-血糖-体重指数预测脂肪肝患者的高血压风险

Prediction of Hypertension Risk in Patients with Fatty Liver Disease Using the Triglyceride-Glucose-Body Mass Index.

作者信息

Gao Ge, Li Haitao, Xu Zhikai, Ge Xiaochun, Li Shuying, Gao Yu

机构信息

Graduate School of Chengde Medical University, Chengde, Hebei, 067000, People's Republic of China.

Department of Endocrinology, Affiliated Hospital of Chengde Medical University, Hebei Key Laboratory of Panvascular Diseases, Chengde, Hebei, 067000, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Sep 6;18:3271-3281. doi: 10.2147/DMSO.S535535. eCollection 2025.

DOI:10.2147/DMSO.S535535

PMID:40949085

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12423249/

Abstract

PURPOSE

Fatty liver disease (FLD) and hypertension (HTN) exhibit a bidirectional relationship: FLD elevates HTN risk, while HTN accelerates FLD progression to fibrosis. Research on this link is limited, with insulin resistance (IR) proposed as a key mechanism. The triglyceride-glucose-body mass index (TyG-BMI), an emerging IR marker, is poorly characterized regarding its association with FLD and HTN. This study assessed TyG-BMI's predictive value for HTN risk in FLD patients and its clinical significance.

PATIENTS AND METHODS

A retrospective cohort of 6,257 FLD patients confirmed by ultrasonography from the Health Examination Center of Chengde Medical University was analyzed. Participants were categorized into FLD-HTN (n=2,804) and normotensive FLD (FLD-0, n=3,453) groups based on blood pressure measurements. Multivariable logistic regression models adjusted for confounders assessed TyG-BMI's independent association with HTN risk. Receiver operating characteristic (ROC) curve analysis, with DeLong's test, compared the discriminative ability of TyG-BMI against conventional indices (BMI and TyG index). Additionally, quartile-based stratification (Q1-Q4) further explored dose-response relationships.

RESULTS

Multivariable-adjusted models showed a 1.6% increase in HTN risk for each unit increase in TyG-BMI (OR=1.016, 95% CI: 1.014-1.018, < 0.001). A significant positive correlation was found between TyG-BMI and both systolic (r=0.264) and diastolic blood pressure (r=0.263, both < 0.001). ROC curve analysis demonstrated that TyG-BMI (AUC=0.624) outperformed BMI (AUC=0.593) and the TyG index (AUC=0.603) (DeLong's test, <0.01) in discriminating HTN risk. Notably, individuals in the highest TyG-BMI quartile (Q4) had a 3.38-fold higher risk of HTN compared to those in the lowest quartile (Q1) (OR=3.380, 95% CI: 2.842-4.020).

CONCLUSION

TyG-BMI is a significant predictor of HTN risk in FLD patients, offering a clinically useful tool for targeted prevention strategies.

摘要

目的

脂肪肝疾病（FLD）与高血压（HTN）呈现双向关系：FLD会增加HTN风险，而HTN会加速FLD向纤维化进展。关于这种关联的研究有限，胰岛素抵抗（IR）被认为是关键机制。甘油三酯 - 葡萄糖 - 体重指数（TyG - BMI）作为一种新兴的IR标志物，其与FLD和HTN的关联特征尚不明确。本研究评估了TyG - BMI对FLD患者HTN风险的预测价值及其临床意义。

患者与方法

对承德医学院健康体检中心经超声检查确诊的6257例FLD患者进行回顾性队列分析。根据血压测量结果，将参与者分为FLD - HTN组（n = 2804）和血压正常的FLD组（FLD - 0，n = 3453）。采用调整了混杂因素的多变量逻辑回归模型评估TyG - BMI与HTN风险的独立关联。采用DeLong检验的受试者工作特征（ROC）曲线分析比较了TyG - BMI与传统指标（BMI和TyG指数）对HTN风险的判别能力。此外，基于四分位数的分层（Q1 - Q4）进一步探讨了剂量 - 反应关系。

结果

多变量调整模型显示，TyG - BMI每增加一个单位，HTN风险增加1.6%（OR = 1.016，95%CI：1.014 - 1.018，P < 0.001）。TyG - BMI与收缩压（r = 0.264）和舒张压（r = 0.263，均P < 0.001）均呈显著正相关。ROC曲线分析表明，在判别HTN风险方面，TyG - BMI（AUC = 0.624）优于BMI（AUC = 0.593）和TyG指数（AUC = 0.603）（DeLong检验，P < 0.01）。值得注意的是，TyG - BMI最高四分位数（Q4）的个体患HTN的风险是最低四分位数（Q1）个体的3.38倍（OR = 3.380，95%CI：2.842 - 4.020）。