Triglyceride glucose index may predict hypertension risk in rural Chinese adults
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Elevated triglyceride glucose index and its dynamic change were positively associated with risk for incident hypertension among rural Chinese adults, according to research published in Nutrition, Metabolism & Cardiovascular Diseases.
“Application of the hyperinsulinemic-euglycemic clamp test, the ‘gold standard’ method for assessing insulin sensitivity, is limited in clinical settings as it is time consuming and expensive,” Dongsheng Hu, MD, of the department of epidemiology and health statistics at Zhengzhou University College of Public Health, Zhengzhou, China, and colleagues wrote in the study background. “Interestingly, the triglyceride glucose index, a fasting blood glucose and triglyceride synthesis parameter, has been proposed to be a persuasive indicator of insulin resistance and suitable for use in the general population since it is cheap and readily available. Despite suggestions that insulin resistance may be involved in the pathogenesis of hypertension by mediating systemic inflammation, the association between triglyceride glucose index and hypertension incidence based on population levels is still controversial, with relevant studies mostly of cross-sectional design or based on small sample populations.”
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In a prospective study, Hu and colleagues analyzed data from 10,309 adults without hypertension at baseline, recruited in 2007-2008 for the Rural Chinese Cohort Study, a prospective study conducted in Henan Province, China, which focused on risk factors, disease patterns and incidence trends for noncommunicable diseases (39.45% men). Follow-up occurred in 2013-2014; researchers defined hypertension as mean systolic BP of at least 140 mm Hg and/or mean diastolic BP or at least 90 mm Hg and/or current use of antihypertensive medication. Researchers calculated triglyceride-glucose index and estimated ORs to assess the association of obesity-hypertension incidence.
The findings were published in Nutrition, Metabolism & Cardiovascular Diseases.
Triglyceride-glucose index and hypertension
During a median follow-up of 6 years, 2,073 participants developed hypertension.
Compared with participants in the lowest triglyceride-glucose index quartile, ORs for incident hypertension were 1.09 for participants in quartile 2 (95% CI, 0.92-1.29), 1.19 for those in quartile 3 (95% CI, 1-1.41), and 1.3 for those in quartile 4 (95% CI, 1.08-1.57).
In a logistic regression model adjusted for age, sex, alcohol drinking, smoking status, physical activity, education, monthly income and family history of hypertension, risk for hypertension was 1.14 (95% CI, 1.07-1.22) for per 1 standard deviation increase in triglyceride-glucose index. After adjusting for the additional risk factor of obesity, the association was no longer significant, according to researchers, with an OR of 1.06 when adjusting for BMI (95% CI, 0.99-1.13) and an OR of 1.05 when adjusting for waist circumference (95% CI, 0.99–1.13).
The researchers observed increasing trends for hypertension incidence as triglyceride-glucose index changed, independent of obesity status (P for trend < .05).
With each SD increment in triglyceride glucose index change, risk for hypertension incidence was 1.15 (95% CI, 1.08-1.22) for relative triglyceride-glucose index change. Results persisted after further adjustment for BMI or waist circumference, respectively.
Additionally, the triglyceride-glucose index partially mediated the obesity-incident hypertension association by 6.84% for BMI and 6.68% for waist circumference, respectively.
Possible predictor of hypertension
“[Data] suggests that baseline triglyceride-glucose index and its dynamic changes are positively associated with risk of hypertension in the Chinese population, but the relationship between baseline triglyceride-glucose index and hypertension may be weakened or removed after controlling for obesity (BMI or waist circumference),” the researchers wrote. “Triglyceride-glucose index, an easily obtained indicator of insulin resistance, could be applied as a predictor of hypertension risk in general population. In addition, triglyceride-glucose index partially mediated the obesity-hypertension incidence association.”
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