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BMI, insulin resistance influence hypertension development
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BMI and insulin resistance as measured via the triglyceride glucose index share a “reciprocal” association that can influence the development of hypertension, according to findings published in Nutrition, Metabolism & Cardiovascular Diseases.
“In recent years, some scholars have proposed triglyceride glucose (TyG) index as an important indicator of insulin resistance, which is fasting blood glucose and triglyceride synthesis index,” Liqiang Zheng, MD, PhD, of the department of clinical epidemiology, library, department of health policy and hospital management at Shengjing Hospital of China Medical University in Shenyang, China, and colleagues wrote. “For this reason, TyG index was applied instead of insulin resistance in this study to explore the temporal relationship with BMI.”
Zheng and colleagues collected demographic and medical history information from questionnaires and measured weight, height, blood pressure, fasting plasma glucose and triglycerides from 4,081 adults aged at least 35 years from the Northeast China Rural Cardiovascular Health Study cohort. Baseline measurements were taken between January and August 2012, and follow-up measurements were collected between August 2015 and January 2016 with a median of 2.42 years between assessments. Participants were included only if they did not report the use of antihypertensive, hypoglycemic and lipid-lowering medications.
Hypertension was diagnosed in 671 participants during the study, and this equated to a 67.92 per 1,000 person-years incidence rate. The researchers found an association between elevated BMI at baseline and elevated TyG index at follow-up (beta = 0.552; P < .001), as well as an association between elevated TyG index at baseline and BMI at follow-up (beta = 0.005; P = .022). In terms of elevated hypertension risk, a significant association was found for therelationship between elevated TyG index at baseline and elevated BMI at follow-up (OR = 1.005; 95% CI, 1.001-1.01), but the researchers noted that the significance of such an association was only “marginal” for the relationship between elevated BMI at baseline and elevated TyG index at follow-up (OR = 1.025; 95% CI, 0.998-1.053).
The researchers also conducted cross-lagged panel analysis to create path coefficients for the relationships between BMI and TyG index. Compared with a mean of zero, the coefficient for BMI at baseline to TyG index at follow-up was 0.043 and for TyG index at baseline to BMI at follow-up was 0.135 (P < .001 for both). The researchers further added that 38.45% of the relationship between BMI and hypertension was mediated by TyG index at follow-up: 57.35% in men and 25.24% in women.
“The most striking observation from the present study was that TyG is associated with risk of incidence hypertension and the temporal relationship between BMI and TyG index is reciprocal,” the researchers wrote. “This study would provide important additional insights into the pathophysiological mechanisms of BMI and insulin resistance to hypertension.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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