Predictive Performance of Triglyceride-Glucose Index on Asymptomatic Multiple Organ Damage in Patients with Newly Diagnosed Hypertension.

Ahmet Kivrak, Alp Yildirim
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Abstract

Background: Insulin resistance (IR) contributes to the development of hypertension and mediated organ damage (HMOD) through various mechanisms.

Objectives: The objective of the study was to assess the diagnostic performance of the triglyceride-glucose (TyG) index, a surrogate marker of IR, in predicting the presence and severity of HMOD in newly diagnosed untreated hypertensive patients from an academic training and research hospital

Methods: The study included 438 patients with newly diagnosed, untreated hypertension. The control group comprised normotensive individuals matched on a 1:1 ratio based on age, gender, body mass index, and smoking using the nearest neighbor method. The presence of HMOD was defined by renal damage (microalbuminuria > 30 mg/day or proteinuria > 150 mg/day), vascular damage (carotid intima-media thickness > 0.9 mm or presence of plaque), or cardiac damage (left ventricular mass index > 95 g/m2 in women and > 115 g/m2 in men). The severity of HMOD was considered as single-, two-, or triple-organ damage.

Results: TyG index values were higher in the hypertensive group than the normotensive group. An increased TyG index was independently associated with HMOD (OR: 1.33, p < 0.001). The TyG index exhibited gradually increasing threshold values for distinguishing patients with single-organ HMOD (> 8.8 with 77.8% sensitivity and 74.3% specificity), two-organ HMOD (> 9.1 with 77.6% sensitivity and 71.4% specificity), and triple-organ HMOD (> 9.4 with 71.5% sensitivity and 87.7% specificity).

Conclusions: In newly diagnosed hypertensive patients, the TyG index exhibits significant diagnostic performance in predicting multiple-organ damage beyond the presence of HMOD. Since the detection of multiple-organ HMOD requires a multidisciplinary approach, the TyG index can serve as a simple and inexpensive screening tool.

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甘油三酯-葡萄糖指数对新诊断高血压患者无症状多器官损伤的预测作用。
背景:胰岛素抵抗(IR)通过多种机制参与高血压和介导的器官损伤(HMOD)的发展。目的:本研究的目的是评估甘油三酯-葡萄糖(TyG)指数(IR的替代标志物)在预测一家学术培训和研究医院新诊断的未经治疗的高血压患者HMOD的存在和严重程度方面的诊断性能。方法:本研究纳入438例新诊断、未经治疗的高血压患者。对照组包括血压正常的个体,根据年龄、性别、体重指数和吸烟情况,采用最近邻法按1:1的比例进行匹配。HMOD的存在由肾损伤(微量白蛋白尿>30 mg/天或蛋白尿>150 mg/天)、血管损伤(颈动脉内膜-中层厚度>0.9 mm或存在斑块)或心脏损伤(女性左心室质量指数>95 g/m2,男性>115 g/m2)定义。HMOD的严重程度被认为是单个、两个或三个器官损伤。结果:高血压组的TyG指数高于血压正常组。TyG指数的增加与HMOD独立相关(OR:1.33,p<0.001)。TyG指数在区分单器官HMOD(>8.8,敏感性77.8%,特异性74.3%)、双器官HMOD>9.1,敏感性77.6%,特异性71.4%)和三器官HMOD患者(>9.4,敏感性71.5%,特异性87.7%)时表现出逐渐增加的阈值。结论:在新诊断的高血压患者中,TyG指数在预测HMOD以外的多器官损伤方面表现出显著的诊断性能。由于多器官HMOD的检测需要多学科的方法,TyG指数可以作为一种简单而廉价的筛查工具。(REV-INVEST-CLIN.2023;75(5):221-32)。
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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
60
审稿时长
>12 weeks
期刊介绍: The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews. Types of manuscripts: – Brief Communications – Research Letters – Original Articles – Brief Reviews – In-depth Reviews – Perspectives – Letters to the Editor
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