Insulin Resistance is Associated With Skin Microvascular Dysfunction and Reduced Circulating Endothelial Progenitor
Ya-Wen Lu1,2,3, Chun-Chin Chang3,4, Ruey-Hsing Chou3,4,5
1Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Journal of Clinical Hypertension (Greenwich, Conn.)
|May 21, 2026
Summary
The triglyceride-glucose (TyG) index, a marker for insulin resistance, is linked to poorer vascular health in hypertensive patients. Higher TyG index values correlate with reduced circulating endothelial progenitor cells (cEPCs) and impaired microvascular function.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Vascular Biology
Background:
- Microvascular dysfunction is an early sign of vascular damage in hypertension and cardiometabolic disorders.
- Insulin resistance (IR) is closely linked to vascular dysfunction.
- The triglyceride-glucose (TyG) index is a practical marker for IR, while circulating endothelial progenitor cells (cEPCs) and microvascular reactivity are markers of vascular health.
Purpose of the Study:
- To investigate the relationship between the TyG index, cEPCs, microvascular reactivity, and cholesterol efflux capacity (CEC) in hypertensive patients.
- To explore the association between IR, as indicated by the TyG index, and markers of vascular health.
Main Methods:
- Cross-sectional study using coronary angiography registry data from 259 hypertensive patients.
- Measurements included cEPC levels, post-occlusive reactive hyperemia (PORH) for microvascular function, CEC, and TyG index.
- Weighted multivariable linear regression analyses were used to examine associations.
Main Results:
- Higher TyG index values were independently associated with lower cEPC levels and impaired microvascular reactivity (PORH) after adjusting for risk factors.
- A 1 SD increase in TyG index correlated with an 11% decrease in cEPCs and a 6.3% reduction in PORH.
- No association was found between the TyG index and CEC.
Conclusions:
- The association of the TyG index with reduced cEPCs and impaired microvascular function in hypertensive patients supports a link between metabolic dysfunction and microvascular impairment.
- These findings highlight the role of IR in microvascular damage within this high-risk population.
- Causal relationships could not be inferred from this cross-sectional study.
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