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Published on: March 25, 2016
TyG Index and Related Indices Predicting Hypertension: Mediation by Neutrophil-to-Lymphocyte Ratio in Multiple
Mengwen Sun1, Yuanyuan Huang2, Na Luo3
1Department of Preventive Medicine, The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou 350122, China.
Insights
The triglyceride-glucose (TyG) index and related measures predict new cases of hypertension. Systemic inflammation, indicated by neutrophil-to-lymphocyte ratio (NLR), partially explains this link.
Area of Science:
- Cardiovascular Disease Epidemiology
- Metabolic Syndrome Research
- Biomarker Discovery
Background:
- Hypertension is a major global health issue linked to insulin resistance and inflammation.
- The predictive value of the triglyceride-glucose (TyG) index and its variants for hypertension is not well-established.
- Investigating novel biomarkers for hypertension risk is crucial for public health.
Purpose of the Study:
- To evaluate the triglyceride-glucose (TyG) index and its obesity-adjusted variants (TyG-WHtR, TyG-WC) as predictors of incident hypertension.
- To explore the mediating role of neutrophil-to-lymphocyte ratio (NLR) in the association between TyG indices and hypertension.
- To analyze these associations across multiple large-scale Chinese cohorts.
Main Methods:
- Analysis of data from 31,224 participants across three Chinese cohorts (Fuqing, CHNS, CHARLS).
- Calculation of TyG indices using fasting triglycerides, glucose, and anthropometric measurements.
- Logistic and Cox regression models, adjusted for confounders, and mediation analysis using NLR.
Main Results:
- Elevated TyG index and its variants consistently predicted incident hypertension across all cohorts (p < 0.001).
- A 1-unit increase in TyG index was associated with a 9-36% increased odds of hypertension.
- Neutrophil-to-lymphocyte ratio (NLR) mediated 20.4-29.4% of the association between TyG indices and hypertension.
Conclusions:
- The TyG index and its related indices are robust predictors of new-onset hypertension.
- Neutrophil-to-lymphocyte ratio (NLR) plays a significant mediating role, accounting for approximately 25% of the observed associations.
- Findings highlight the interplay of metabolic dysregulation and inflammation in hypertension, suggesting integrated biomarker strategies for risk assessment.
Abstract:
Background: Hypertension remains a leading cause of cardiovascular morbidity and mortality globally, and insulin resistance (IR) and systemic inflammation are implicated in the pathogenesis of hypertension. Limited evidence exists on the predictive role of the triglyceride-glucose (TyG) index and its related indices (TyG-WHtR and TyG-WC) for hypertension. This study aimed to investigate these associations across multiple Chinese cohorts. Methods: Data from 31,224 participants (Fuqing, CHNS, CHARLS) were analyzed. TyG indices were calculated using fasting triglycerides, glucose, and anthropometrics. Hypertension was defined as SBP/DBP ≥ 140/90 mmHg, or physician diagnosis, or antihypertensive treatment. Logistic/Cox regression models were used to examine associations, adjusting for demographics, lifestyle, and metabolic factors. Mediation analysis quantified the role of neutrophil-to-lymphocyte ratio (NLR) in mediating the TyG-hypertension relationship. Results: Elevated TyG index and its obesity-adjusted variants consistently predicted incident hypertension across cohorts (all p < 0.001). Each 1-unit TyG increase was associated with 9-36% higher odds of hypertension in Fuqing (OR = 1.09-1.36). NLR mediated 20.4-29.4% of these associations (p < 0.001). Subgroup analyses revealed effect modifications by age, sex, and residence. Sensitivity analyses confirmed robustness when redefining hypertension thresholds (ACC/AHA criteria). Conclusions: TyG index and its related indices are robust predictors of (new-onset) hypertension, with NLR statistically accounting for approximately 25% of these associations in the mediation model. These findings underscore the interplay between metabolic dysregulation, inflammation, and hypertension and advocate for integrated biomarker strategies in risk stratification and prevention, while external validation in multi-ethnic populations is warranted.
