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Updated: Jun 19, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Metabolic biomarkers and cardiovascular risk stratification in hypertension
D Piskorz1, L Keller1, L Citta1
1Cardiology Institute of the Rosario British Sanatorium, Rosario, Argentina.
Insights
High triglyceride-glucose index (TyGi), a marker for insulin resistance, is linked to increased cardiovascular risk in hypertensive individuals. TyGi correlates with other insulin resistance biomarkers, suggesting its clinical utility for risk stratification.
Area of Science:
- Endocrinology
- Cardiology
- Preventive Medicine
Background:
- Cardiovascular risk calculators (CRC) lack local validation.
- Surrogate biomarkers for insulin resistance can identify individuals at higher risk for type 2 diabetes and cardiovascular disease (CVD).
Purpose of the Study:
- To determine the prevalence of insulin resistance surrogate biomarkers.
- To assess the correlation between these biomarkers and CRC in non-diabetic hypertensive patients undergoing primary prevention.
Main Methods:
- Observational registry with prospective consecutive outpatients.
- Calculation of the triglyceride-glucose index (TyG index): Ln (fasting triglycerides × fasting plasma glucose / 2).
- Stratification by TyG index quartiles and evaluation of Pearson correlation coefficients.
Main Results:
- The study included 406 hypertensive patients (56.9% male, mean age 55.9 years).
- Higher TyG index quartiles correlated with increased ASCVD risk (p=0.02) and higher frequency of AHA/ACC Pooled Cohort Equation risk >7.5% (p<0.005).
- Significant correlations were found between TyG index and TG/HDL ratio (r=0.7076, p<0.0001) and non-HDL cholesterol (r=0.4553, p<0.0001).
Conclusions:
- Non-diabetic hypertensive patients with elevated TyG index exhibit higher 10-year cardiovascular risk.
- The TyG index is a reliable surrogate biomarker for insulin resistance and correlates significantly with other metabolic biomarkers.
- TyG index may serve as a valuable tool for cardiovascular risk stratification in clinical practice.
Introduction:
Cardiovascular risk calculators (CRC) are not locally validated and calibrated. Surrogate biomarkers of insulin resistance had identified subjects at higher risk of type 2 diabetes and cardiovascular disease.
Aim:
Establish the frequency of surrogate biomarkers of insulin resistance and their correlation with CRC in primary prevention non-diabetic hypertensive subjects.
Methods:
This is an observational registry with a prospective consecutive outpatient's sample. The TyG index (TyGi) was calculated as logarithm (Ln) of (fasting triglycerides [mg/dl]×fasting plasma glucose [mg/dl]/2). Patients were stratified according to quartiles of TyGi. Pearson correlation coefficient between TyGi and other relevant variables was evaluated.
Results:
Four hundred six patients were included with a mean age 55.9±13 years, 231 p (56.9%) males. The mean TyGi was 8.667±0.53. Patients in the highest quartiles of TyGi had significantly higher median difference between expected and actual ASCVD risk (p=0.02), higher frequency of AHA/ACC Pooled Cohort Equation >7.5% (p<0.005), and higher levels of metabolic biomarkers such as median triglyceridemia/HDL cholesterol ratio (TG/HDL) (p<0.0005), glycaemia and A1C (p<0.001 and p=0.02, respectively). The correlation between TyGi and TG/HDL was highly significant (r=0.7076; r2=0.5007; p<0.0001), and intermediate with non-HDL cholesterol (r=0.4553, r2=0.2073; p<0.0001).
Conclusions:
Non-diabetic hypertensive patients with high TyGi, a surrogate biomarker of insulin resistance, had a higher 10-year cardiovascular risk by AHA/ACC Pooled Cohort Equation. TyGi is statistically and significantly correlated with other biomarkers of insulin resistance. TyGi could be a reliable biomarker in clinical practice to stratify cardiovascular risk.
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