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Association Between Metabolic and Atherogenic Indices and Circadian Blood Pressure Patterns in White-Coat

Arzu Akgul1, Cigdem Ikhlef1, Çağatay Tunca2

  • 1Division of Nephrology, Department of Internal Medicine, Ankara Etlik City Hospital, 06710 Ankara, Turkey.

Medicina (Kaunas, Lithuania)
|February 27, 2026
PubMed

Insights

Metabolic biomarkers like the triglyceride-glucose (TyG) index and uric acid are linked to non-dipper patterns in white-coat hypertension. Higher levels of these markers indicate a greater risk of nighttime blood pressure issues.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Hypertension Research

Background:

  • Cardiovascular event risk increases with insufficient nighttime blood pressure reduction in hypertensive patients.
  • Non-dipper patterns, characterized by a lack of nocturnal blood pressure dip, are associated with adverse cardiovascular outcomes.
  • White-coat hypertension requires understanding factors contributing to circadian blood pressure dysregulation.

Purpose of the Study:

  • To investigate the association between metabolic and inflammatory biomarkers and the non-dipper pattern in patients with newly diagnosed white-coat hypertension.
  • To identify specific biomarkers that can predict the non-dipper status in this patient population.

Main Methods:

  • A cohort of 244 newly diagnosed white-coat hypertension patients was studied.
  • Ambulatory blood pressure monitoring classified patients into dipper (n=86) and non-dipper (n=158) groups.
  • Metabolic markers (triglyceride-glucose index, atherogenic index of plasma, uric acid, BMI) and inflammatory markers (neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio) were assessed.

Main Results:

  • Non-dipper patients exhibited significantly higher levels of uric acid, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), and body mass index (BMI) compared to dippers.
  • No significant differences were observed in inflammatory markers between the groups.
  • Uric acid demonstrated the highest discriminative ability for non-dipper status (AUC=0.722).
  • Elevated uric acid and TyG index were independently associated with an increased likelihood of non-dipper status.

Conclusions:

  • Metabolic biomarkers, including the TyG index, uric acid, BMI, and AIP, are elevated in white-coat hypertension patients with a non-dipper pattern.
  • The TyG index, uric acid levels, and BMI are independently associated with the non-dipper pattern.
  • These metabolic biomarkers may aid in identifying individuals at higher risk for circadian blood pressure dysregulation and associated cardiovascular events.

Keywords:
Triglyceride-Glucose indexatherogenic indexhypertensioninflammatory markersuric acid

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