Key result
A higher baseline triglyceride-glucose (TyG) index was associated with a significantly lower risk of probable dementia (HR 0.66) in older hypertensive patients without diabetes.
Why the study?
Previous studies in patients with diabetes failed to find an association between insulin resistance and cognitive function, and the relationship between insulin resistance and cognitive outcomes under intensive blood pressure control had not been investigated.
Does a higher TyG index associate with a reduced risk of probable dementia in hypertensive patients without diabetes?
Cohort (n=9,323)
Yes
Does a higher TyG index associate with a reduced risk of probable dementia in hypertensive patients without diabetes?
In hypertensive patients without diabetes, a higher TyG index is associated with a lower risk of probable dementia, demonstrating an L-shaped relationship.
Answers are grounded in this paper and cite their sources.
TyG index may flag cognitive risk in diabetes; leaves open whether IR affects cognition or improves prediction.
Background Previous observational studies in patients with diabetes have examined the relationship between insulin resistance (IR) and cognitive outcomes and failed to find that IR is associated with cognitive function. And the triglyceride-glucose (TyG) index, which measured serum triglyceride (TG) and fasting blood glucose (FBG), has been suggested as a surrogate reliable marker of IR and widely used due to its convenience and cost-effectiveness.However, to the best of our knowledge, the relationship between IR and intensive blood pressure control in specific cognitive outcomes has never been investigated. Methods To fill this knowledge gap, we analyzed the relationship between TYG levels and cognitive outcomes in hypertensive patients within the Systolic Blood Pressure Intervention Trial (SPRINT). The SPRINT evaluated the impact of intensive blood pressure control (systolic blood pressure < 120 mmHg) versus standard blood pressure control (systolic blood pressure < 140 mmHg). The Cox proportional risk regression was used to investigate the association between different TYG status and clinical outcomes. Additional stratified analyzes were performed to evaluate the robustness of gender difference. Results A total of 9,323 participants (6016 [64.53%] males and 3307 [35.47%] females) with hypertension from the SPRINT research were included in the analysis. The median follow-up period was 3.26 years. Our population was divided into three groups according to the size of the TyG index. The low TyG group was the reference. Sensitivity analyzes showed that in the SPRINT, the TyG index was significantly associated with the risk of cognitive outcomes across various subgroups. There was no significant interaction in the confounders. Conclusions In this cohort study, results suggest that patients with TyG levels higher had lower risk of probable dementia, but this study tested association, not causation. Our results demonstrated that in patients with hypertension, the association between TyG and risk of probable dementia is L-shaped.
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Liu et al. (2023) conducted a cohort in Hypertension without diabetes (n=9,323). Triglyceride-glucose (TyG) index vs. Low TyG index (first tertile) was evaluated on Probable dementia (HR 0.66, 95% CI 0.48-0.91, p=0.0115). A higher baseline triglyceride-glucose (TyG) index was associated with a significantly lower risk of probable dementia (HR 0.66) in older hypertensive patients without diabetes.
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