The TyG-WHtR index as a novel predictor of nocturnal hypertension in metabolic syndrome

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Metabolic syndrome (n=180). Intervention: Triglyceride-glucose index to waist-to-height ratio (TyG-WHtR) (per 1-unit increase) vs. Lower TyG-WHtR index (continuous per 1-unit). Primary outcome: Nocturnal hypertension (mean nighttime SBP ≥120 mmHg and/or DBP ≥70 mmHg) (OR 17.27, 95% CI 5.76–58.87, p=1.35×10−6).

Q: What does this research mean for the field?

The triglyceride-glucose to waist-to-height ratio (TyG-WHtR) index is independently associated with nocturnal hypertension in patients with metabolic syndrome and exhibits superior discriminative ability compared to the TyG index alone. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Yanqiu Li; Hailong Su; Duan Wang; Xinlian Duan; Qin Zhang

doi:10.3389/fcvm.2026.1941261

November 3, 2026Frontiers in Cardiovascular MedicineOpen Access

The TyG-WHtR index as a novel predictor of nocturnal hypertension in metabolic syndrome

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Key result

Higher TyG-WHtR linked to ~17.3-fold higher odds of nocturnal hypertension per unit increase.

OR 17.27
95% CI 5.76–58.87
P 1.35×10−6
n=180

Why the study?

The association between the triglyceride-glucose index to waist-to-height ratio (TyG-WHtR) and nocturnal hypertension in patients with metabolic syndrome had not been established.

Is the TyG-WHtR index independently associated with and predictive of nocturnal hypertension in adults with metabolic syndrome?

Key Points

To assess the relationship between the triglyceride-glucose index to waist-to-height ratio (TyG-WHtR) and nocturnal hypertension in patients with metabolic syndrome.
Cross-sectional study of 180 adults diagnosed with metabolic syndrome who underwent 24-hour ambulatory blood pressure monitoring.
Nocturnal hypertension was defined as mean nighttime systolic blood pressure ≥120 mmHg and/or diastolic blood pressure ≥70 mmHg.
Evaluated multivariable logistic regression adjusted for age, sex, BMI, eGFR, and antihypertensive medication use, alongside ROC curve analysis.
Nocturnal hypertension was identified in 48.3% of participants (87 of 180), with a significantly higher TyG-WHtR index compared to normotensive peers (5.7 ± 0.5 vs. 5.1 ± 0.4, p = 6.05×10−13).
After multivariable adjustment, TyG-WHtR remained independently associated with nocturnal hypertension (OR: 17.27, 95% CI: 5.76–58.87, p = 1.35×10−6).
The ROC analysis yielded an AUC of 0.794 (95% CI: 0.73–0.86) with an optimal cutoff of 5.65 (sensitivity 56.3%, specificity 91.4%), performing significantly better than the TyG index alone (AUC 0.676, p = 0.002).

Study Design

Type

Cross-Sectional (n=180)

Multicenter

No

Structured PICO

Is the TyG-WHtR index independently associated with and predictive of nocturnal hypertension in adults with metabolic syndrome?

P

Population

180 adults with metabolic syndrome (mean age 59.2 years, 47.8% female), free of known cardiovascular disease, secondary hypertension, and renal impairment, undergoing 24-hour ambulatory blood pressure monitoring.

E

Exposure

Triglyceride-glucose index to waist-to-height ratio (TyG-WHtR), calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] × [waist circumference (cm) / height (cm)]

C

Comparator

Individual components: Triglyceride-glucose (TyG) index alone and waist-to-height ratio (WHtR) alone, and comparison between nocturnal hypertension vs. non-nocturnal hypertension groups

O

Outcome

Nocturnal hypertension, defined as mean nighttime (23:00–07:00) systolic blood pressure ≥120 mmHg and/or diastolic blood pressure ≥70 mmHg measured via 24-hour ambulatory blood pressure monitoringsurrogate

Main Result

Odds Ratio: 17.27 (95% CI 5.76–58.87)

p-value: p=1.35×10−6

The composite TyG-WHtR index is independently associated with nocturnal hypertension in metabolic syndrome patients and provides better discriminative ability than the TyG index alone, though its incremental value over waist-to-height ratio alone is not statistically significant.

Limitations

Cross-sectional design does not permit causal inference
Single-center recruitment from a tertiary care center may introduce selection bias and limit generalizability
Residual confounding from unmeasured variables such as dietary habits, physical activity, or sleep quality cannot be excluded
MetS was diagnosed using 2005 IDF criteria rather than 2009 harmonized criteria
Unmeasured factors influencing nocturnal blood pressure, including obstructive sleep apnea, sleep duration, and timing of antihypertensive medication administration
Residual confounding from unmeasured variables such as dietary habits, physical activity, obstructive sleep apnea, sleep quality/duration, and timing of antihypertensive medication administration
Metabolic syndrome was diagnosed using 2005 IDF criteria rather than 2009 harmonized criteria
Incremental discriminative value of TyG-WHtR over WHtR alone did not reach statistical significance (p = 0.078)

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Implication

TyG-WHtR association with nocturnal hypertension should not change practice; hypothesis-generating for prospective validation in metabolic syndrome.

Abstract

Objective To investigate the association between triglyceride-glucose index to waist-to-height ratio (TyG-WHtR) and nocturnal hypertension in metabolic syndrome (MetS) patients. Methods This cross-sectional study included 180 adults with MetS undergoing 24-hour ambulatory blood pressure monitoring. Nocturnal hypertension was defined as mean nighttime SBP ≥120 mmHg and/or DBP ≥70 mmHg. Multivariable logistic regression and ROC analysis were performed. Results Nocturnal hypertension was present in 48.3% of participants. TyG-WHtR was significantly higher in the nocturnal hypertension group (5.7 ± 0.5 vs. 5.1 ± 0.4, p = 6.05×10 −13 ). After adjustment for confounders, TyG-WHtR remained independently associated with nocturnal hypertension (OR: 17.27, 95% CI: 5.76–58.87, p = 1.35×10 −6 ). The AUC was 0.794 (95% CI: 0.73–0.86), with optimal cutoff 5.65 (sensitivity 56.3%, specificity 91.4%). Conclusions TyG-WHtR was independently associated with nocturnal hypertension in MetS patients and showed acceptable discriminative ability, significantly better than the TyG index alone.

Discussion

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Cite This Study

Li et al. (2026) conducted a cross-sectional in Metabolic syndrome (n=180). Triglyceride-glucose index to waist-to-height ratio (TyG-WHtR) (per 1-unit increase) vs. Lower TyG-WHtR index (continuous per 1-unit) was evaluated on Nocturnal hypertension (mean nighttime SBP ≥120 mmHg and/or DBP ≥70 mmHg) (OR 17.27, 95% CI 5.76–58.87, p=1.35×10−6). Higher TyG-WHtR was independently associated with nocturnal hypertension in metabolic syndrome patients (adjusted OR 17.27 per 1-unit increase, 95% CI 5.76–58.87; AUC 0.794).

synapsesocial.com/papers/6aebc8cf3e63ca1b6c315ecb https://doi.org/10.3389/fcvm.2026.1941261

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The TyG-WHtR index as a novel predictor of nocturnal hypertension in metabolic syndrome

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The TyG-WHtR index as a novel predictor of nocturnal hypertension in metabolic syndrome

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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