| Objective: Insulin resistance is an important mechanism contributing to the development of hypertension.The triglyceride-glucose index(TyG index)is an important indicator of insulin resistance.This study intends to investigate the relationship between TyG index and blood pressure,arterial stiffness,atherosclerosis,and risk of hypertension in a natural population to provide a scientific basis for the prevention and treatment of hypertension.Methods: Residents of a community in Dali were invited to participate in this study from September 2018 to November 2018,and all participants signed an informed consent form.A total of 750 residents were invited to participate,and after excluding subjects with incomplete information,a total of 715 study subjects were finally included in the statistical analysis.A standardized questionnaire was used to collect demographic information,lifestyle,history of previous diseases,and information on medication use.Fasting blood was collected for triglyceride,fasting glucose,and fasting insulin measurements,and the TyG index and homeostatic model assessment for insulin resistance(HOMA-IR)were calculated.Brachial blood pressure was measured five times continuously using a mercury sphygmomanometer,and the mean values were taken for statistical analysis.Brachial-ankle pulse wave velocity(ba PWV)and ankle-brachial blood pressure index(ABI)were measured using VP-2000.Carotid-femoral pulse wave velocity(cf PWV)and aortic blood pressure were measured using Sphygmo Cor XCEL.Carotid intima-media thickness(IMT)was measured,and the carotid plaque was assessed using vascular ultrasound.Hypertension was defined as blood pressure ≥140/90 mm Hg or a previous diagnosis of hypertension and current antihypertensive treatment.Peripheral artery disease was defined as ABI<0.9.Data were managed and statistically analyzed using SAS 9.4 and Empower software.Results:1.Grouped by TyG index tertile,the prevalence of hypertension and diabetes increased gradually with increasing levels of TyG index,brachial blood pressure,aortic blood pressure,pulse rate,ba PWV,cf PWV,and IMT,and more hypertensive patients were treated with antihypertensive therapy.2.Multiple linear regression analysis revealed that TyG index was independently associated with increased brachial and aortic diastolic blood pressure with or without adjusting for covariates such as sex,age,body mass index,smoking,alcohol consumption,and antihypertensive treatment.After adjusting for the above covariates,each 1-unit increase in TyG index was associated with a 1.38 mm Hg increase in brachial diastolic pressure(95% CI 0.13,2.64,P=0.0310)and a 2.38 mm Hg increase in aortic diastolic blood pressure(95% CI 1.11,3.65,P=0.0002).Compared with the lowest tertile group,the highest tertile group had an increase in brachial diastolic pressure of 2.66 mm Hg(95% CI 0.69,4.64,P=0.0084)and aortic diastolic blood pressure of 3.96 mm Hg(95% CI 1.97,5.95,P=0.0001).TyG index was not independently associated with brachial and aortic systolic blood pressure.3.Logistic regression analysis revealed that the TyG index was an independent risk factor for risk of hypertension.Each 1-unit increase in TyG index was associated with a 46% increased risk of hypertension(OR1.46,95% CI 1.09,1.96,P=0.0121).The risk of hypertension was increased by 95% in the highest tertile group compared with the lowest tertile group(OR1.95,95% CI 1.22,3.14,P=0.0057).4.Multiple linear regression analysis revealed that the TyG index was independently associated with ba PWV and cf PWV but not with IMT and ABI,with or without adjusting for the covariates of sex,age,body mass index,smoking,alcohol consumption,and antihypertensive treatment.After adjusting for the above covariates,cf PWV increased by 0.34 m/s(95% CI 0.14,0.53,P=0.0007)for each1-unit increase in the TyG index.Compared with the lowest tertile,ba PWV was56.01 cm/s higher in the highest tertile group(95% CI 1.48,110.54,P=0.0445),and cf PWV increased by 0.58 m/s(95% CI 0.28,0.89,P=0.0002).However,there was no independent association between the TyG index and carotid atheromatous plaque and peripheral artery disease.5.After adjusting for covariates,the TyG index and atherosclerosis were significantly associated.Each 1-unit increase in TyG index was associated with a77% increased risk of ba PWV>1800 cm/s(OR1.77,95% CI 1.21,2.58,P=0.0030)and a 54% increased risk of cf PWV>11 m/s(OR1.54,95% CI 1.15 2.06,P=0.0040).Compared to the lowest tertile,the highest tertile group had a 303%increased risk of ba PWV>1800cm/s(OR3.03,95% CI 1.54,5.96,P=0.0013)and a240% increased risk of cf PWV>11m/s(OR2.40,95% CI 1.49,3.89,P=0.0004).6.Compared with HOMA-IR,the TyG index had a higher predictive value for atherosclerosis whether atherosclerosis was defined using ba PWV>1800cm/s(AUC0.620 vs.0.528,P=0.0011)or cf PWV>11m/s(AUC0.651 vs.0.570,P<0.0001).Conclusion: In this study population,the TyG index was independently associated with atherosclerosis and peripheral and central arterial diastolic blood pressure and was an independent risk factor for hypertension prevalence,with a higher predictive value for atherosclerosis than HOMA-IR. |
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