Triglyceride glucose (TyG)-body mass index (BMI) and other TyG-related indices were significantly associated with new-onset hypertension in women, according to a study in the Journal of the American Heart Association (JAHA).
The TyG index is calculated using fasting triglyceride and blood glucose. It is associated with insulin resistance and risk of hypertension and cardiovascular disease. The combination of TyG-related markers and body composition indices, such as BMI, waist circumference (WC), and waist-to-height ratio (WtHR), have a greater predictive ability for metabolic diseases than TyG alone.
The JAHA study utilized data from the Korean Genome and Epidemiology Study to identify sex differences in the utility of TyG alone and in combination with other indices for assessing the risk of hypertension. Adults aged 40-69 years at baseline (2001-2002) with at least 1 follow-up visit between 2003 and 2016 were included in the analysis (n=5,414). The cohort included 2,568 men and 2,846 women.
The mean follow-up period was 9.5 years. New-onset hypertension was diagnosed in 1,014 men and 1,024 women. New cases of hypertension were more likely in participants who were older and male compared with their peers. Participants who developed new-onset hypertension had higher levels of TyG and TyG-BMI, TyG-WC, and TyG-WtHR. There were differences in mean levels of TyG, TyG-BMI, TyG-WC, and TyG-WtHR. TyG was significantly associated with sex (p=.003).
Hazard ratios (HRs) for new-onset hypertension were calculated according to sex-specific tertile groups after adjusting for confounders. Compared with the lowest tertile, TyG-BMI in the third tertile was significantly associated with incident hypertension in women (HR=1.55; p=.011) but not in men (HR=1.11; p=.759). After adjustment, third-tertile levels of TyG, TyG-WC, and TyG-WtHR were all significantly associated with new-onset hypertension in men and women, with the following adjusted HRs:
- TyG: 1.16 for men, 1.37 for women
- TyG-WC: 1.77 for men, 1.43 for women
- TyG-WtHR: 1.68 for men, 1.64 for women
The combination of TyG with WC and WtHR demonstrated superior predictive performance than TyG alone or TyG-BMI in both men and women. In men, Harrell’s C-indices were significantly higher for TyG-WC and TyG-WtHR (0.595 and 0.599, respectively), compared with 0.576 and 0.576 for TyG and TyG-BMI (p<.001). Similarly, C-indices for TyG-WC and TyGWtHR for women were 0.639 and 0.650, respectively, which was significantly higher than TyG and TyG-BMI (0.588 and 0.599, respectively; p<.001).
“The current study revealed a significant association between TyG and TyG‐BMI and the incidence of hypertension, especially among women. TyG‐WC and TyG‐WtHR were significantly associated with new‐onset hypertension in both men and women,” the authors concluded. “Further research is warranted when employing TyG and modified TyG indices for identifying individuals at risk of developing incident hypertension, while considering sex differences.”