甘油三酯-葡萄糖指数与肥胖指标的联合作用对老年人群高血压患病风险的影响-现代医学

甘油三酯-葡萄糖指数与肥胖指标的联合作用对老年人群高血压患病风险的影响

单位：南京市疾病预防控制中心慢性非传染病防制科, 江苏南京 210003

分类号：R544.1

出版年·卷·期（页码）：2024·52·第七期（1050-1056）

摘要：

目的：评估甘油三酯-葡萄糖指数(TyG指数)与肥胖等指标对南京地区老年人群高血压患病风险的影响。方法：以2017至2018年开展的南京市慢性病及其危险因素监测数据中7 362例60岁以上老年人群为研究对象，根据TyG指数四分位数将研究对象分为4组，TyG指数＜8.205为Q1组，8.205≤TyG指数＜8.538为 Q2组，8.538≤TyG指数＜8.892 为Q3组，TyG指数≥8.892为Q4组。采用二水平Logistic 回归模型，分析TyG指数与肥胖等指标对高血压患病的影响，采用受试者工作特征(ROC)曲线评估TyG指数及其他肥胖指标对高血压罹患风险的预测作用。结果：在调整变量包括年龄、性别、地区、学历、婚姻状况、吸烟、饮酒、身体活动、食盐摄入和家族史后，结果显示，以Q1组为参照，Q2组、Q3组和Q4组高血压患病风险较高，OR分别为1.265(95%CI 1.089~1.470)、1.397(95%CI 1.208~1.616)和1.730(95%CI 1.495~2.002)；体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)超标组高血压患病风险均高于参照组，OR分别为1.979(95%CI 1.792~2.185)、1.843(95%CI1.657~2.049)、1.267(95%CI 1.144~1.403)和1.838(95%CI 1.660~2.035)。TyG指数(二分类)与各肥胖指标分别联合产生新变量，与两变量均为低水平相比，其中1个变量为高水平，或者二者皆为高水平，高血压的患病风险均增加，差异均有统计学意义(均P＜0.01)。TyG+BMI(0.572)、TyG+WC(0.564)以及TyG+WHtR(0.567)预测高血压罹患风险的曲线下面积(AUC)均高于TyG单独预测高血压的AUC(0.532)。结论：南京地区老年人高血压患病风险随TyG指数水平的升高而增加，TyG指数可能对高血压的发病风险具有重要的预测价值，且与肥胖指标对高血压患病风险具有联合效应。

Objective: To evaluate the impact of the triglyceride-glucose index(TyG index) and obesity indicators on the risk of hypertension among the elderly in Nanjing. Methods： Using the chronic disease and risk factor surveillance data collected in Nanjing from 2017 to 2018, focusing on the 7 362 participants aged 60 and above, all participants were divided into 4 groups according to the quartile of the TyG index. TyG index<8.205 was the Q1 group, 8.205≤TyG index<8.538 was the Q2 group, 8.538≤TyG index<8.892 was the Q3 group, and the TyG index ≥8.892 was the Q4 group.The effect of the TyG index and obesity indicators on hypertension was analyzed using a multilevel Logistic regression model. The receiver operating characteristic(ROC) curve was employed to assess the predictive role of the TyG index and other obesity indicators on the risk of developing hypertension. Results: After adjusting for variables including age, gender, region, education level, marital status, smoking, drinking, physical activity, salt intake, and family history, the risk of hypertension was higher in Q2, Q3, and Q4 group than that of Q1 group, the odds ratios(OR) were 1.265(95%CI 1.089-1.470), 1.397(95%CI 1.208-1.616), and 1.730(95%CI 1.495-2.002), respectively. The risk of hypertension in the group with excessive body mass index(BMI), waist circumference(WC), waist to hip ratio(WHR), and waist to height ratio(WHtR) was also higher than that in the non excessive group, with OR were 1.979(95%CI 1.792-2.185), 1.843 (95%CI 1.657-2.049), 1.267(95%CI 1.144-1.403) and 1.838(95%CI 1.660-2.035), respectively. Participants were divided into four subgroups by TyG index and obesity indicators respectively, compared with the lower level of both variables, one variable with high level or both of them with high level, the risk of hypertension increased, and the differences were significant(P<0.01). The AUC for predicting the risk of hypertension were higher when combining TyG with BMI(0.572), TyG with WC(0.564), and TyG with WHtR(0.567) than that of TyG index alone(0.532). Conclusion: In the elderly of the Nanjing area, the risk of developing hypertension increases with the rise in the level of the TyG index. The TyG index may have significant predictive value for the risk of hypertension, and it has a combined effect with obesity indicators on the risk of developing hypertension.

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