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Temporal relationship between triglyceride-glucose index and blood pressure and their joint cumulative effect on
Kuangyi Wu1,2, Huancong Zheng1,2, Weiqiang Wu1,2
1Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxia North RD., Shantou, 515000, China.
Insights
Elevated Triglyceride-Glucose Index (TyG) significantly impacts future blood pressure, increasing cardiovascular disease (CVD) risk, especially in younger individuals. Managing both insulin resistance and blood pressure is key for CVD prevention.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Epidemiology
Background:
- Concurrent insulin resistance and elevated blood pressure are common in cardiovascular disease (CVD).
- The temporal relationship and cumulative exposure effects on incident CVD remain unclear.
Purpose of the Study:
- To investigate the temporal relationship between the Triglyceride-Glucose Index (TyG) and blood pressure (BP).
- To assess the impact of cumulative co-exposure to TyG and BP on future CVD risk.
Main Methods:
- Longitudinal analysis of 56,313 non-CVD participants from the Kailuan Study.
- Cross-lagged analyses to determine the temporal relationship between TyG and BP.
- Cox regression models to evaluate hazard ratios for cumulative TyG (CumTyG) and BP (CumBP) on CVD outcomes.
Main Results:
- Elevated TyG showed a greater impact on future BP changes than vice versa.
- Significant interactions were observed between cumulative TyG and cumulative BP thresholds for CVD risk.
- Increased CVD risk was associated with higher cumulative co-exposure to TyG and BP, particularly in younger individuals.
Conclusions:
- Elevated TyG influences future blood pressure, highlighting a bidirectional relationship.
- Dual assessment and management of insulin resistance and blood pressure are crucial for CVD prevention.
- Intervention strategies should prioritize younger individuals due to heightened CVD risk from co-exposure.
Background:
Concurrent insulin resistance and elevated blood pressure are commonly observed in cardiovascular disease (CVD) and have long been proposed to contribute to CVD. However, the temporal relationship between them and the effect of their cumulative co-exposure on future incident CVD remains unclear.
Methods:
Longitudinal analysis of data on 57,192 participants from a real-world, prospective cohort study (Kailuan Study) was performed to address the temporal relationship between Triglyceride-Glucose Index (TyG, calculated as ln [TG (mg/dL) × FBG (mg/dL)/2]) and blood pressure (BP) assessed by cross-lagged analyses in an approximately 4-year exposure period (2006/2007 to 2010/2011). After excluding 879 participants with known diabetes, 56,313 nonCVD participants were included for further analysis of the CVD outcome. Cox regression models were used to examine the hazard ratios (HRs) upon the cumulative TyG (CumTyG) and BP(CumBP) in the exposure period.
Results:
The standard regression coefficient from baseline TyG to follow-up systolic BP was 0.0142 (95% CI 0.0059-0.0226), which was greater than the standard regression coefficient from baseline systolic BP to follow-up TyG (- 0.0390; 95% CI - 0.0469 to - 0.0311). The same results were observed in the cross-lag between TyG and diastolic blood pressure [0.0271 (0.0185 to 0.0356) vs. - 0.0372 (- 0.0451 to - 0.0293)]. During a median follow-up of 9.98 years, 3981 CVD cases occurred. Significant interactions were observed between the median CumTyG (8.61) and CumSBP thresholds (130, 140 mmHg) (P = 0.0149), the median CumTyG (8.61) and CumDBP thresholds (80, 90 mmHg) (P = 0.0441). Compared to CumTyG < 8.61 and CumSBP < 130 mmHg, after adjusting for potential confounding factors, the HR gradually increased in the high co-exposure groups. The hazard ratios (HRs) and 95% confidence intervals (CIs) for Q2-Q6 were 1.39 (1.24, 1.57), 1.94 (1.69, 2.22), 2.40 (2.12, 2.71), 2.74 (2.43, 3.10), and 3.07 (2.74, 3.45). Additionally, the CVD risks in the co-exposure were more prominent in younger participants.
Conclusions:
These findings suggest that elevated TyG has a greater impact on future blood pressure changes than vice versa. Dual assessment and management of insulin resistance and blood pressure contribute to the prevention of CVD, especially in younger individuals.
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