Associations of Novel Triglyceride- and Triglyceride–Glucose-Derived Obesity Indices with Hypertension in Nonobese US Adults (NHANES 1999--2020)

Background Visceral obesity, insulin resistance (IR), and glycolipid abnormalities are associated with an increased risk of hypertension (HTN). The study aimed to explore the correlation between novel triglyceride- and triglyceride‒glucose-derived obesity indices associated with these hypertension risk factors, and the prevalence of HTN among nonobese adults. Methods We extracted data from 12,717 nonobese adults from NHANES between 1999—2020 and calculated triglyceride-derived obesity indices (lipid accumulation product (LAP), visceral adiposity index (VAI), and cardiometabolic index (CMI)), triglyceride-glucose-derived obesity indices (triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist circumference (TyG-WC), and triglyceride glucose-waist-to-height ratio (TyG-WHtR)) and traditional anthropometric indices. Logistic regression, curve fitting and subgroup analyses were employed to investigate the associations between these novel obesity indices and HTN prevalence. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive accuracy of all the above obesity parameters. Results After weighted analysis of the data, the results of this study represented approximately 119.00 million nonobese U.S. adults. The prevalence of HTN was 49.74% (men 53.45%). The multivariate logistic regression analysis revealed that LAP, VAI, CMI, TyG-BMI, TyG-WC and TyG-WHtR were significantly associated with HTN. Smoothed curve-fitting analysis revealed that the LAP, VAI and CMI correlated nonlinearly with HTN. The area under the curve (AUC) for HTN was greater for all novel obesity indices compared to commonly used traditional anthropometric parameters such as BMI, WC, and WHtR. Conclusions LAP, VAI, CMI, TyG-BMI, TyG-WC, and TyG-WHtR were significantly associated with HTN and demonstrated potentially better predictive capability than commonly used traditional anthropometric measures.