Temporal Relationship Between Waist-hip Ratio And Triglyceride-glucose Index And Its Impact On The Incident Of Hypertension

Objectives:Obesity and insulin levels can influence each other through metabolism.However,their time series relationship and their effects on hypertension are generally unknown.This study aims to explore the relationship between waist-to-hip ratio（WHR）and triglyceride-glucose index（Ty G）and its effect on hypertension.Methods:In 2013,a multi-stage random cluster sampling method was used to establish a cardiovascular disease research cohort in rural areas of Dwa,Zhangwu,and Liaoyang County,Liaoning Province,and patients≥35 years old were collected from August 2015 to January 2016.Rural residents conduct follow-up surveys.Cross-lagged panel analysis was used to describe the temporal relationship between WHR and Ty G in the population,and then the mediation effect model was constructed to analyze its impact on hypertension.Results:This study included 4974 subjects with an average follow-up time of2.41±0.27 years,of which 48.9%were male.In the general population,waist-to-hip ratio and Ty G influence each other,and the two are in no sequence[baseline Ty G→follow-up WHR path coefficient（ρ₁=0.072,P<0.001）and baseline WHR→follow-up Ty G path coefficient（ρ₂=0.046）,P<0.001),andρ₁>ρ₂,ρ₁vsρ₂,P=0.194],and the difference between synchronization correlation（r₁）and tracking correlation（r₂,r₃）in the model is statistically significant（all P<0.001）.However,in the female population,Ty G unilaterally affects WHR[baseline Ty G→path coefficient for follow-up waist-hip ratio（ρ₁=0.040,P=0.004）,baseline WHR→path coefficient for follow-up Ty G（ρ₂=0.004,P=0.836）)],the difference between synchronization correlation（r₁）and tracking correlation（r₂,r₃）in the model was statistically significant（both P<0.001）.In addition,the percentage of mediating effects of WHR-hypertension mediated by Ty G index in the total population is estimated to be16.67%（P<0.001）.Conclusions:To sum up,there is a temporal correlation between WHR and insulin resistance in adults in rural areas of Northeast China,and the two influences are not prioritized.This relationship plays a vital role in the development of hypertension.This study will provide an important supplementary understanding of the pathophysiological mechanism of WHR and insulin resistance to hypertension,and further provide a scientific basis for future clinical practice.