Association between TyG-VAI and hypertension in children and adolescents based on machine learning algorithms

Q: What are the key findings of this study?

The highest quartile of the TyG-VAI was independently associated with a 2.36-fold increased odds of hypertension compared to the lowest quartile in children and adolescents.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=27991). Intervention: Triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) highest quartile vs. TyG-VAI lowest quartile. Primary outcome: Hypertension (systolic or diastolic blood pressure at or above the 95th percentile) (OR 2.36, 95% CI 2.02-2.76, p=<0.001).

Q: What does this research mean for the field?

TyG-VAI is independently and positively associated with hypertension in children and adolescents, an association primarily mediated by waist-to-height ratio. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the association between the triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) and hypertension in children and adolescents, and to assess its predictive utility using machine learning algorithms.

Jialiang Zhu; Chen Zhang; Qirui Zhang; Gang Tian; Jingge Zhao; Mengwei Wang; Zhanfeng Liu; Min Liu; Yibin Hao

doi:10.1038/s41598-026-75405-3

October 13, 2026Scientific ReportsOpen Access

Association between TyG-VAI and hypertension in children and adolescents based on machine learning algorithms

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Key result

Highest TyG-VAI quartile linked to ~2.4-fold higher odds of pediatric hypertension.

OR 2.36
95% CI 2.02-2.76
P<0.001
n=27,991

Why the study?

Hypertension in children and adolescents is increasingly prevalent, and effective risk indicators such as TyG-VAI have limited evidence in this population.

Is a higher TyG-VAI associated with an increased risk of hypertension in children and adolescents?

Key Points

To evaluate the association between the triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) and hypertension in children and adolescents, and to assess its predictive utility using machine learning algorithms.
Cross-sectional survey enrolling 27,991 children and adolescents in Henan Province, China, between 2023 and 2024 using multi-stage sampling.
Multivariate logistic regression models, subgroup comparisons, mediation analyses, and 11 machine learning algorithms were used to evaluate hypertension associations and prediction accuracy.
Hypertension prevalence rose monotonically from 4.2% in quartile 1 of TyG-VAI to 11.4% in quartile 4 (P for trend < 0.001), remaining independently associated in the fully adjusted model for quartile 3 (OR = 1.49, 95% CI 1.27–1.76, P < 0.001) and quartile 4 (OR = 2.36, 95% CI 2.02–2.76, P < 0.001).
Subgroup analyses revealed greater sensitivity in males (fully adjusted OR = 2.65, 95% CI 2.19–3.20, P < 0.001) compared with females (fully adjusted OR = 1.89, 95% CI 1.43–2.50, P < 0.001) in the highest TyG-VAI quartile.
Waist-to-height ratio mediated 62.2% (95% CI 55.4–70.9) of the total effect, followed by uric acid (22.6%) and the creatinine index (21.2%), while a multi-layer perceptron model demonstrated the highest predictive performance (AUC = 0.7518).

Study Design

Type

Cross-Sectional (n=27,991)

Multicenter

Yes

Structured PICO

Is a higher TyG-VAI associated with an increased risk of hypertension in children and adolescents?

P

Population

27,991 children and adolescents aged 6.2 to 21.6 years from Henan Province, China, without severe mental or cognitive impairment, evaluated in a cross-sectional survey.

E

Exposure

Highest quartile of the triglyceride-glucose index combined with visceral adiposity index (TyG-VAI)

C

Comparator

Lowest quartile of the triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) (1st quartile group)

O

Outcome

Hypertension, defined as a systolic or diastolic blood pressure at or above the 95th percentile of the corresponding age-, sex- and height-specific percentile curves

Main Result

Odds Ratio: 2.36 (95% CI 2.02–2.76)

Absolute Event Rate: 11.4% vs 4.2%

p-value: p=<0.001

TyG-VAI is a strong independent indicator of hypertension risk in children and adolescents, which can enhance early risk prediction when integrated with machine learning models.

Limitations

Cross-sectional design cannot establish causal relationships between TyG-VAI, mediators, and hypertension.
No external validation of the machine learning prediction model was performed.
VAI index and thresholds were derived from adult cohorts and have not been prospectively validated in pediatric populations.
Study was restricted to a single province, potentially limiting generalizability.
Cross-sectional design means temporal ordering required for causal mediation cannot be established.
No external validation was performed in an independent cohort.

Implication

TyG-VAI was associated with hypertension in children and adolescents; leaves open its screening utility pending prospective validation.

Abstract

Hypertension in children and adolescents is increasingly prevalent, and effective risk indicators are needed. The triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) has proved useful in adults, but evidence in the paediatric population remains limited. In this cross-sectional survey, 27,991 children and adolescents were enrolled in Henan Province, China, between 2023 and 2024 using multi-stage sampling. Multivariate logistic regression, subgroup and mediation analyses, and 11 machine learning models were used to examine the association between TyG-VAI and hypertension and to assess its predictive value. TyG-VAI was positively associated with hypertension (odds ratio [OR] = 2.36 for the highest quartile, P < 0.001), with greater sensitivity in males. Waist-to-height ratio was the main mediator (62.2%), followed by uric acid and the creatinine index. The multi-layer perceptron model incorporating TyG-VAI showed the best predictive performance (area under the curve [AUC] = 0.7518). TyG-VAI was independently associated with hypertension in children and adolescents and improved risk prediction, providing a basis for early intervention in this population.

Discussion

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Cite This Study

Zhu et al. (2026) conducted a cross-sectional in Hypertension (n=27,991). Triglyceride-glucose index combined with visceral adiposity index (TyG-VAI) highest quartile vs. TyG-VAI lowest quartile was evaluated on Hypertension (systolic or diastolic blood pressure at or above the 95th percentile) (OR 2.36, 95% CI 2.02-2.76, p=<0.001). The highest quartile of the TyG-VAI was independently associated with a 2.36-fold increased odds of hypertension compared to the lowest quartile in children and adolescents.

synapsesocial.com/papers/6ad0b8f43983294737c0c4db https://doi.org/10.1038/s41598-026-75405-3

Topics

Artificial intelligence in cardiology

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Association between TyG-VAI and hypertension in children and adolescents based on machine learning algorithms

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Association between TyG-VAI and hypertension in children and adolescents based on machine learning algorithms

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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