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河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系

Effect of TyG combined with obesity indicators on prevalence of hypertension and hyperuricemia comorbidity among residents aged 35 years and older in Hebei province: a surveillance data analysis

    摘要
  • 摘要:
    目的 了解河北省≥35岁居民三酰甘油–葡萄糖乘积指数（TyG）和不同肥胖指标与高血压合并高尿酸血症患病的关系，为该地区居民高血压合并高尿酸血症的防治提供参考依据。
    方法 收集2020年4—12月河北省心血管病及其危险因素监测项目10个监测点调查中7 859名≥35岁常住居民的相关数据，应用多因素非条件logistic回归模型分析TyG和超重/肥胖、中心型肥胖、腰高比（WHtR）等不同肥胖指标与高血压合并高尿酸血症患病的关系，计算TyG与不同肥胖指标对高血压合并高尿酸血症患病的相加交互作用，并采用受试者工作特征（ROC）曲线下面积（AUC）评估TyG和不同肥胖指标对高血压合并高尿酸血症患病的预测价值。
    结果 河北省纳入分析的7 859名≥35岁居民中，非超重/肥胖者2 415人（30.73%），超重/肥胖者5 444人（69.27%）；非中心型肥胖者3 442人（43.80%），中心型肥胖者4 417人（56.20%）；非高WHtR者2 413人（30.70%），高WHtR者5 446人（69.30%）；低TyG（≤8.42）者3 475人（44.22%），高TyG（≥8.43）者4 384人（55.78%）；患高血压合并高尿酸血症者939例，高血压合并高尿酸血症患病率为11.95%。在调整了性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况和是否糖尿病等混杂因素后，多因素非条件logistic回归分析结果显示，河北省≥35岁中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁非中心型肥胖居民的1.676倍（OR=1.676，95%CI=1.346～2.087），≥35岁超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁非超重/肥胖居民的1.440倍（OR=1.440，95%CI=1.148～1.807），≥35岁高WHtR居民高血压合并高尿酸血症患病风险为≥35岁非高WHtR居民的1.297倍（OR=1.297，95%CI=1.001～1.679），≥35岁高TyG居民高血压合并高尿酸血症患病风险为≥35岁低TyG居民的2.335倍（OR=2.335，95%CI=1.974～2.763）；TyG与不同肥胖指标对高血压合并高尿酸血症患病均存在相加交互作用，≥35岁高TyG且超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非超重/肥胖居民的5.159倍（OR=5.159，95%CI=3.916～6.796），≥35岁高TyG且中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非中心型肥胖居民的5.587倍（OR=5.587，95%CI=4.357～7.164），≥35岁高TyG且高WHtR居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非WHtR居民的5.326倍（OR=5.326，95%CI=4.038～7.026）；ROC分析结果显示，TyG+腰围（WC）对高血压合并高尿酸血症的预测效力优于TyG+体质指数（BMI）、TyG+WHtR和单一TyG指标，AUC为0.725（95%CI=0.715～0.735）。
    结论 高TyG、超重/肥胖、中心型肥胖和高WHtR均可增加河北省≥35岁居民高血压合并高尿酸血症的患病风险，且TyG与不同肥胖指标间存在相加交互作用，可将TyG+WC作为预测高血压合并高尿酸血症患病的有效指标。

     

    Abstract:
    Objective To investigate the effect of the triglyceride-glucose index (TyG) combined with various obesity indicators on the prevalence of comorbid hypertension and hyperuricemia among residents aged 35 years and older in Hebei province, and to provide a reference for the prevention and treatment of this comorbidity in the population.
    Methods Data from 7 859 permanent residents aged 35 years and older were collected as part of the Cardiovascular Disease and Risk Factor Surveillance Project, conducted in 10 districts/counties/cities of Hebei province between April and December 2020. A multivariable logistic regression model was used to analyze the relationship between the TyG, overweight/obesity, central obesity, and waist-to-height ratio (WHtR) with the prevalence of comorbid hypertension and hyperuricemia. The additive interaction between TyG and different obesity indicators on the prevalence of comorbid hypertension and hyperuricemia was assessed using relative excess risk due to interaction (‌RERI). The predictive value of TyG and different obesity indicators for comorbid hypertension and hyperuricemia was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
    Results Among 7 859 surveyed residents, 30.73% (2 415) were non-overweight/obese, while 69.27% (5 444) were overweight/obese; 43.80% (3 442) were non-centrally obese, and 56.20% (4 417) were centrally obese; 30.70% (2 413) had a normal WHtR, and 69.30% (5 446) had a high WHtR; 44.22% (3 475) had a low TyG (≤ 8.42), and 55.78% (4 384) had a high TyG (≥ 8.43). Additionally, 11.95% (939) had comorbid hypertension and hyperuricemia. After adjusting for sex, age, education, residence, physical activity, current smoking, alcohol consumption, and diabetes, multivariable logistic regression analysis revealed a significantly increased risk of comorbid hypertension and hyperuricemia among residents with central obesity (odds ratio OR=1.676, 95% confidence interval 95%CI: 1.346-2.087), overweight or obesity (OR=1.440, 95%CI: 1.148-1.807), high WHtR (OR=1.297, 95%CI: 1.001-1.679), and high TyG (OR=2.335, 95%CI: 1.974-2.763), compared to residents who were not centrally obese, not overweight or obese, had normal WHtR, and had low TyG. The multivariable logistic regression results also showed significantly higher risks of comorbid hypertension and hyperuricemia among residents with both high TyG and high obesity indicators, including overweight or obesity (OR=5.159, 95%CI: 3.916-6.796), central obesity (OR=5.587, 95%CI: 4.357-7.164), and high WHtR (OR=5.326, 95%CI: 4.038-7.026), compared to residents with low TyG and no overweight or obesity, no central obesity, and low WHtR, indicating an additive interaction between TyG and obesity indicators in comorbid hypertension and hyperuricemia. ROC analysis demonstrated that TyG combined with waist circumference (WC) had a higher predictive power for comorbid hypertension and hyperuricemia (AUC=0.725, 95%CI: 0.715-0.735), indicating better diagnostic accuracy compared to TyG combined with body mass index (BMI), TyG combined with WHtR, or TyG alone.
    Conclusions High TyG, overweight/obesity, central obesity, and high WHtR are all associated with an increased risk of hypertension combined with hyperuricemia in residents aged 35 years and older in Hebei province. An additive interaction exists between TyG and different obesity indicators. TyG combined with WC could serve as an effective predictor for hypertension combined with hyperuricemia.

     

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