Abstract：
OBJECTIVE: Insulin resistance (IR) has previously been associated with hypertension, and obesity is a risk factor for IR and hypertension. There is likely an association between body mass index (BMI) and risk for hypertension through the triglyceride-glucose (TyG) index but this relationship remains uncharacterized.
RESULTS: This study is based on the Hanzhong Adolescent Hypertension Cohort, which is an ongoing prospective study established in 1987. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trend of BMI, respectively. We found that BMI AUCt and BMI AUCi were significantly associated with the risk of adult hypertension, both without (RR = 1.30/1.31 for BMI AUCt/AUCi) and with (RR = 1.25/1.26 for BMI AUCt/AUCi) the inclusion of the TyG index as a covariate. Importantly, mediation analysis revealed that the TyG index mediated the BMI AUCt-SBP association (19.3%), the BMI AUCt-DBP association (22.7%), the BMI AUCi-SBP association (18.5%) and the BMI AUCi-DBP association (21.3%). Furthermore, the TyG index had a significant mediating effect of 15.9% on the BMI AUCt-hypertension association and 14.9% on the BMI AUCi-hypertension association.
CONCLUSIONS: These findings suggest that the TyG index plays an important mediating role in the association between the cumulative burden and increasing trends of BMI originating in childhood and the risk of hypertension in midlife. We emphasize that early weight management has the potential to reduce the burden of hypertension caused by IR.
BACKGROUND: The study was clinically registered at the ClinicalTrials.gov (NCT02734472) and approved by the Academic Committee of the First Affiliated Hospital of Xi\'an Jiaotong University (XJTU1AF2015LSL-047).
RESULTS: This study is based on the Hanzhong Adolescent Hypertension Cohort, which is an ongoing prospective study established in 1987. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trend of BMI, respectively. We found that BMI AUCt and BMI AUCi were significantly associated with the risk of adult hypertension, both without (RR = 1.30/1.31 for BMI AUCt/AUCi) and with (RR = 1.25/1.26 for BMI AUCt/AUCi) the inclusion of the TyG index as a covariate. Importantly, mediation analysis revealed that the TyG index mediated the BMI AUCt-SBP association (19.3%), the BMI AUCt-DBP association (22.7%), the BMI AUCi-SBP association (18.5%) and the BMI AUCi-DBP association (21.3%). Furthermore, the TyG index had a significant mediating effect of 15.9% on the BMI AUCt-hypertension association and 14.9% on the BMI AUCi-hypertension association.
CONCLUSIONS: These findings suggest that the TyG index plays an important mediating role in the association between the cumulative burden and increasing trends of BMI originating in childhood and the risk of hypertension in midlife. We emphasize that early weight management has the potential to reduce the burden of hypertension caused by IR.
BACKGROUND: The study was clinically registered at the ClinicalTrials.gov (NCT02734472) and approved by the Academic Committee of the First Affiliated Hospital of Xi\'an Jiaotong University (XJTU1AF2015LSL-047).
摘要：
目的：胰岛素抵抗（IR）以前与高血压有关，肥胖是IR和高血压的危险因素。体重指数（BMI）与通过甘油三酸酯-葡萄糖（TyG）指数的高血压风险之间可能存在关联，但这种关系仍未表征。
结果：本研究基于汉中青少年高血压队列，这是一项正在进行的前瞻性研究，成立于1987年。将TyG指数计算为ln[空腹甘油三酯(mg/dl)X空腹血浆葡萄糖(mg/dl)/2]。计算曲线下总面积（AUCt）和增量AUC（AUCi）作为BMI的长期负担和趋势，分别。我们发现BMIAUCt和BMIAUCi与成人高血压的风险显著相关,两者都没有(RR=1.30/1.31对于BMIAUCt/AUCi)和(RR=1.25/1.26对于BMIAUCt/AUCi)纳入TyG指数作为协变量。重要的是,中介分析显示，TyG指数介导了BMIAUCt-SBP关联(19.3%)，BMIAUCt-DBP协会（22.7%），BMIAUCi-SBP关联（18.5%）和BMIAUCi-DBP关联（21.3%）。此外，TyG指数对BMIAUCt-高血压关联的中介效应为15.9%,对BMIAUCi-高血压关联的中介效应为14.9%.
结论：这些研究结果表明，TyG指数在儿童时期BMI的累积负担和增加趋势与中年高血压风险之间的关系中起着重要的中介作用。我们强调，早期体重管理有可能减轻IR引起的高血压负担。
背景：该研究在ClinicalTrials.gov（NCT02734472）进行了临床注册，并获得了西安交通大学第一附属医院学术委员会的批准（XJTU1AF2015LSL-047）。
结果：本研究基于汉中青少年高血压队列，这是一项正在进行的前瞻性研究，成立于1987年。将TyG指数计算为ln[空腹甘油三酯(mg/dl)X空腹血浆葡萄糖(mg/dl)/2]。计算曲线下总面积（AUCt）和增量AUC（AUCi）作为BMI的长期负担和趋势，分别。我们发现BMIAUCt和BMIAUCi与成人高血压的风险显著相关,两者都没有(RR=1.30/1.31对于BMIAUCt/AUCi)和(RR=1.25/1.26对于BMIAUCt/AUCi)纳入TyG指数作为协变量。重要的是,中介分析显示，TyG指数介导了BMIAUCt-SBP关联(19.3%)，BMIAUCt-DBP协会（22.7%），BMIAUCi-SBP关联（18.5%）和BMIAUCi-DBP关联（21.3%）。此外，TyG指数对BMIAUCt-高血压关联的中介效应为15.9%,对BMIAUCi-高血压关联的中介效应为14.9%.
结论：这些研究结果表明，TyG指数在儿童时期BMI的累积负担和增加趋势与中年高血压风险之间的关系中起着重要的中介作用。我们强调，早期体重管理有可能减轻IR引起的高血压负担。
背景：该研究在ClinicalTrials.gov（NCT02734472）进行了临床注册，并获得了西安交通大学第一附属医院学术委员会的批准（XJTU1AF2015LSL-047）。
