Key result
The TyG index and TyG-BMI were significantly associated with new-onset hypertension only in women (HR 1.37 and 1.55, respectively), whereas TyG-WC and TyG-WHtR predicted hypertension in both men and women.
Why the study?
TyG and TyG-related indices combined with obesity markers reflect insulin resistance, but their sex-stratified associations with and predictive ability for new-onset hypertension required evaluation.
Do the triglyceride-glucose (TyG) index and body composition-modified TyG indices predict new-onset hypertension in middle-aged and older adults, and does this differ by sex?
Cohort (n=5,414)
Do the triglyceride-glucose (TyG) index and body composition-modified TyG indices predict new-onset hypertension in middle-aged and older adults, and does this differ by sex?
Modified TyG indices incorporating waist circumference or waist-to-height ratio are strong, sex-independent predictors of new-onset hypertension, whereas the standard TyG index predicts hypertension only in women.
Waist-modified TyG indices were associated with incident hypertension across sexes; leaves open added predictive value and prospective validation before clinical use.
Background Triglyceride and glucose (TyG) index and TyG-related indices combined with obesity-related markers are considered important markers of insulin resistance. We aimed to examine the association between the TyG index and modified TyG indices with new-onset hypertension and their predictive ability stratified by sex. Methods and Results We analyzed data from 5414 Korean Genome and Epidemiology Study participants aged 40 to 69 years. Multiple Cox proportional hazard regression analyses were conducted to estimate the hazard ratio (HR) and 95% CI for new-onset hypertension according to sex-specific tertile groups after confounder adjustments. To evaluate the predictive performance of these indices for new-onset hypertension, we calculated Harrell's C-index (95% CI). Over a 9.5-year follow-up period, 1014 men and 1012 women developed new-onset hypertension. Compared with the lowest tertile (T) group, the adjusted HR and 95% CI for new-onset hypertension in T3 for TyG, TyG-body mass index, TyG-waist circumference, and TyG-waist-to-height ratio were 1.16 (0.95-1.40), 1.11 (0.84-1.48), 1.77 (1.38-2.27), and 1.68 (1.33-2.13) in men and 1.37 (1.13-1.66), 1.55 (1.16-2.06), 1.43 (1.15-1.79), and 1.64 (1.30-2.07) in women, respectively. The C-indices of TyG-waist-to-height ratio for new-onset hypertension were significantly higher than those of TyG and TyG-body mass index in both men and women. Conclusions TyG and TyG-body mass index were significantly associated with new-onset hypertension only in women. TyG-waist circumference and TyG-waist-to-height ratio were significantly associated with new-onset hypertension in both men and women. A sex-specific approach is required when using TyG and modified TyG indices to identify individuals at risk of incident hypertension.
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Lee et al. (2023) conducted a cohort in New-onset hypertension (n=5,414). Higher triglyceride and glucose (TyG) index and modified TyG indices (TyG-BMI, TyG-WC, TyG-WHtR) vs. Lowest tertile of respective TyG indices was evaluated on New-onset hypertension (TyG index highest vs lowest tertile in women) (HR 1.37, 95% CI 1.13-1.66, p=0.003). The TyG index and TyG-BMI were significantly associated with new-onset hypertension only in women (HR 1.37 and 1.55, respectively), whereas TyG-WC and TyG-WHtR predicted hypertension in both men and women.
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