Objective To investigate the associations of serum triglyceride (TG) levels with various metabolic abnormalities among adult residents in 5 cities of western China, thereby providing evidence for the prevention and management of metabolic syndrome in this region.

Methods A multistage stratified cluster sampling method was used to recruit 990 adult permanent residents ≥18 years old from Chifeng, Hohhot, and Ordos in Inner Mongolia Autonomous Region, Lhasa in Xizang Autonomous Region, and Dali in Yunnan province between March and October 2023. Data were collected through questionnaires, physical examinations, and laboratory tests. Multivariate unconditional logistic regression models were used to analyze the associations between serum TG levels and various metabolic abnormalities, including overweight and obesity, central obesity, hypertension, elevated low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C), elevated total cholesterol (TC), insulin resistance, diabetes, and hyperuricemia.

Results A total of 939 adults were included in the final analysis. Among the surveyed population, 611 (65.0%), 163 (17.4%), and 165 (17.6%) had normal TG levels, borderline high TG, and elevated TG, respectively. The number (detection rates) of respondents with overweight and obesity, central obesity, hypertension, elevated LDL-C, decreased HDL-C, elevated TC, insulin resistance, diabetes, and hyperuricemia was 536 (57.1%), 432 (46.0%), 389 (41.4%), 94 (10.0%), 82 (8.7%), 237 (25.2%), 310 (33.0%), 227(24.2%), and 310 (33.0%), respectively. After adjusting for sex, age group, region, educational background, per capita monthly household income, smoking status, drinking status, physical activity level, and daily intake of cereals, tubers, vegetables, fruits, animal-based foods, dairy products, soy and nuts, salt, and oil, multivariate unconditional logistic regression analyses showed that adults with borderline high TG had higher detection rates of overweight and obesity (OR = 2.70, 95%CI: 1.80–4.04), central obesity (OR = 1.67, 95%CI: 1.13–2.48), hypertension (OR = 1.71, 95%CI: 1.15–2.54), elevated LDL-C (OR = 3.65, 95%CI: 2.03–6.59), elevated TC (OR = 3.42, 95%CI: 2.22–5.26), insulin resistance (OR = 2.65, 95%CI: 1.79–3.90), and hyperuricemia (OR = 2.31, 95%CI: 1.55–3.44) than the adults with normal serum TG levels. Adults with elevated TG had higher detection rates of overweight and obesity (OR = 4.68, 95%CI: 2.96–7.40), central obesity (OR = 4.25, 95%CI: 2.75–6.58), hypertension (OR = 1.83, 95%CI: 1.22–2.74), elevated LDL-C (OR = 4.66, 95%CI: 2.55–8.50), reduced HDL-C (OR = 5.85, 95%CI: 2.59–13.23), elevated TC (OR = 6.24, 95%CI: 3.98–9.79), insulin resistance (OR = 5.22, 95%CI: 3.47–7.83), diabetes (OR = 2.30, 95%CI: 1.50–3.52), and hyperuricemia (OR = 6.41, 95%CI: 4.22–9.73).

Conclusions Elevated serum TG among adults in 5 cities of western China are positively associated with multiple metabolic abnormalities, including overweight and obesity, central obesity, hypertension, elevated LDL-C, decreased HDL-C, elevated TC, insulin resistance, diabetes, and hyperuricemia.