The triglyceride-glucose-waist-to-height ratio is the strongest predictor of reduced kidney function in elderly hypertensive patients.

BACKGROUND

The triglyceride-glucose index (TyG) and its derivatives, such as the TyG-waist-to-height ratio (TyG-WHtR), provide reliable surrogate measures for estimating insulin resistance (IR). Their associations with renal function in hypertensive patients remain unclear. This study examined the associations of TyG-WHtR and its related indices with estimated glomerular filtration rate (eGFR) in a community-based elderly hypertensive population.

METHODS

This cross-sectional study assessed the clinical indicators, TyG-related indices, and eGFR in a cohort of 3,764 hypertensive adults aged ≥65 years from Huaian, China, employing restricted cubic spline models (RCS), logistic regression, spearman correlation, and receiver operating characteristic (ROC) curve analyses to evaluate the associations and predictive utility of TyG-WHtR and related parameters for identifying impaired renal function, defined by reduced eGFR.

RESULTS

A total of 612 participants (16.25%) had reduced eGFR. Significant predictors of reduced eGFR included elevated TyG-WHtR and related indices, with TyG-WHtR showing a particularly robust association in both pre- and post-adjustment analyses. These indices correlated negatively with high-density lipoprotein cholesterol (HDL-C), and positively with measures of adiposity, fasting plasma glucose (FPG), and non-HDL cholesterol. Significant interactions were found for gender, age, and alcohol consumption. TyG-WHtR alone had an AUC of 0.596, but after adjustment its predictive ability improved to 0.864, demonstrating superior performance compared to TyG, TyG-body mass index (TyG-BMI), and TyG-waist circumference (TyG-WC).

CONCLUSION

Elevated TyG-WHtR is an independent risk factor for the decline in eGFR in elderly patients with hypertension, demonstrating superior predictive value compared to other TyG-related indices. TyG-WHtR may serve as a useful marker for early identification of renal dysfunction in this population.