Association between insulin resistant surrogate index and arterial stiffness in hypertensive population: a five year follow-up cohort study

Abstract

Background Causal association between triglyceride-glucose (TyG) index and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio with arterial stiffness remains unclear. This study aims to assess the effect of TyG index and TG/HDL-C ratio on the incidence of arterial stiffness in hypertensive population, and identify the susceptible subgroups. Methods This study enrolled 1201 hypertensive participants without arterial stiffness aged 18 or above in 2013 and 2014 as baseline. Physical examination and biochemical test including fasting blood glucose (FBG), TG, HDL-C were measured. The TyG index was denoted as ln[TG*FBG/2]. Incident arterial stiffness cases were confirmed during the following annual examination by brachial-ankle pulse wave velocity (baPWV, > 1800 cm/s), until December 31 of 2019. The Cox model was used to explore the association of TyG index and TG/HDL-C ratio with the arterial stiffness. Results During a mean follow-up of 5.09 years, 430 cases of arterial stiffness were confirmed. In the multivariate Cox model, the higher TyG index and TG/HDL-C ratio were positively associated with a higher risk of arterial stiffness (adjusted HR for per-unit increase: 1.39 and 1.08, P < 0.05). The adjusted HR (95% CI) comparing participants in the highest quartile versus lowest quartile of TyG and TG/HDL-C ratio were 1.51 (1.10–2.07) and 1.08 (1.01–1.15), respectively. This positive linear association of evaluated TyG index and TG/HDL-C ratio with arterial stiffness was confirmed using restricted cubic spline function. The observed association was stronger in subgroups with overweight, co-diabetes and poor blood pressure control (systolic pressure ≥ 140 mmHg or without anti-hypertension medication). Conclusion The elevated TyG index and TG/HDL-C ratio independently increased the future risk of arterial stiffness in hypertensive population. Monitoring TyG index and TG/HDL-C ratio deserves more attention in clinical practice, especially in the population with overweight, co-diabetes and poor blood pressure control.

Association between the triglyceride-glucose index and arterial stiffness: A meta-analysis

“…2A). Relatively similar outcomes were achieved in 10 studies in which the TyG index was treated as a continuous variable [22,24–28,31–34] (RR: 1.46, 95% CI: 1.32–1.61, I 2 = 77%, P < .001; Fig. 2B).…”

“…Two studies were performed on community residents, [26,34] 2 were conducted on diabetes patients, [28,31] 2 were on older adults, [27,30] and another study was on hypertension patients. [24] Of the PWV measurement procedures, the baPWV was reported in 11 studies, [22][23][24][25][27][28][29][31][32][33] the cfPWV in one, [26] and the other reported both the baPWV and cfPWV. [30,34] As evaluated by the Newcastle-Ottawa Scale, the mean points of the selected studies were 7 to 8.…”

“…Guo 2021 [22] 1.43 1.27-1.62 79 <.001 Li 2020 [24] 1.37 1.27-1.46 55 <.001 Nakagomi 2020 [25] men 1.46 1.30-1.64 79 <.001 Nakagomi 2020 [25] women 1.44 1.28-1.61 80 <.001 Pan 2021 [31] 1.45 1.29-1.64 80 <.001 Poon 2020 [26] 1.48 1.33-1.64 68 <.001 Su 2021 [27] 1.46 1.30-1.63 80 <.001 Wang 2021 [28] 1.45 1.29-1.63 80 <.001 Wu 2020 [32] 1.45 1.29-1.63 80 <.001 Yang 2022 [33] 1.43 1.28-1.60 80 <.001 Ji 2022 [34] 1.44 1.30-1.60 78 <.001 CI = confidence interval, RR = risk ratio, TyG = triglyceride-glucose. baPWV = brachial-ankle pulse wave velocity, cfPWV = carotid-femoral pulse wave velocity, CI = confidence interval, PWV = pulse wave velocity, RR = risk ratio, TyG = triglyceride-glucose.…”

“…Eventually, 13 articles were included in the current meta-analysis. [22][23][24][25][26][27][28][29][30][31][32][33] The procedure for literature selection is illustrated in Figure 1.…”

“…[32] The studies were conducted in China, [22,24,[27][28][29][30][31][32]34] Korea, [23] Japan, [25,33] and the USA. [26] Two were prospective cohort studies, [29,32] while the other 11 were cross-sectional studies. [22][23][24][25][26][27][28]30,31,33] Six studies [22,23,25,29,32,33] included participants who underwent health examinations.…”