Elevated triglyceride-glucose index is a risk factor for progression to prehypertension in normoglycemic Japanese: a 5-year retrospective cohort study.

Abstract

Background: The triglyceride-glucose (TyG) index is an alternative biomarker of insulin resistance that may be associated with elevated blood pressure. However, the relationship between the TyG index and the risk of prehypertension remains unclear. This longitudinal, retrospective cohort study aimed to investigate the connection between the TyG index and the risk among Japanese population.

Methods: We enrolled 17,758 participants who underwent medical health checkups in 2017 (baseline) and 2022. At baseline, all participants were normotensive and normoglycemic state, and none were using triglyceride-lowering medications. Participants were divided into four groups according to quartiles of the TyG index at baseline. The risk of progressing to prehypertension was evaluated using multivariable Cox proportional hazard models. In addition, multivariate restricted cubic spline analysis was conducted to examine the dose-response relationship. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of the TyG index for progression to prehypertension.

Results: Compared with the lowest quartile (Q1) of the TyG index group, the adjusted hazard ratios (95% confidence intervals) for progression to prehypertension in the Q2, Q3, and Q4 groups were 1.05 (0.95-1.19), 1.14 (1.02-1.30), and 1.28 (1.11-1.50), respectively. The restricted cubic spline analysis demonstrated a dose-response relationship between the TyG index and the risk of prehypertension. The area under the ROC curve was 0.60 (0.59-0.61), demonstrating a sensitivity of 56.2% and specificity of 58.8%.

Conclusions: The findings suggest that an elevated TyG index may be independently and positively associated with an increased risk of progression to prehypertension in the Japanese population.