Frontiers in endocrinology · 2026
Association between the triglyceride-glucose index and hypertension: potential role of fatty liver in a cross-sectional study.
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Lin Yuzhan, Sun Ruixue, Wu Lifeng, Chen Lei, Fu Chen, Yan Shaorong, Cai Jianze
Аннотация
BACKGROUND: The triglyceride-glucose (TyG) index is widely recognized as a surrogate marker of insulin resistance and reflects disturbances in glucose and lipid metabolism. Although higher TyG index levels have been associated with hypertension, the factors related to this association remain incompletely understood. This study aimed to examine the association between the TyG index and hypertension and to explore whether fatty liver might statistically account for part of this association.
METHODS: This cross-sectional study included participants who underwent routine health examinations at the Third Affiliated Hospital of Wenzhou Medical University between 2021 and 2025. For individuals with multiple examination records during the study period, only the first record was retained for analysis. The TyG index was calculated using fasting triglyceride and glucose levels. Fatty liver was assessed by abdominal ultrasonography, and hypertension was defined according to the 2023 European Society of Hypertension guidelines. Multivariable logistic regression models were used to evaluate the associations of the TyG index with hypertension and fatty liver. Mediation analysis was performed to explore whether fatty liver might account for part of the observed association between the TyG index and hypertension.
RESULTS: A total of 115,327 participants were included in the final analysis. The TyG index was significantly associated with hypertension. Each 1-unit increase in the TyG index was associated with higher odds of hypertension (adjusted OR = 2.09, 95% CI: 2.03-2.15). The TyG index was also strongly associated with fatty liver (adjusted OR = 7.05, 95% CI: 6.82-7.28). Mediation analysis suggested that fatty liver might account for part of the observed association between the TyG index and hypertension, with a proportion statistically accounted for of 23.50% (95% CI: 21.39%-25.96%).
CONCLUSIONS: In this health examination population, a higher TyG index was significantly associated with hypertension, and fatty liver may account for part of the observed association. Further longitudinal studies are needed to clarify these findings.
METHODS: This cross-sectional study included participants who underwent routine health examinations at the Third Affiliated Hospital of Wenzhou Medical University between 2021 and 2025. For individuals with multiple examination records during the study period, only the first record was retained for analysis. The TyG index was calculated using fasting triglyceride and glucose levels. Fatty liver was assessed by abdominal ultrasonography, and hypertension was defined according to the 2023 European Society of Hypertension guidelines. Multivariable logistic regression models were used to evaluate the associations of the TyG index with hypertension and fatty liver. Mediation analysis was performed to explore whether fatty liver might account for part of the observed association between the TyG index and hypertension.
RESULTS: A total of 115,327 participants were included in the final analysis. The TyG index was significantly associated with hypertension. Each 1-unit increase in the TyG index was associated with higher odds of hypertension (adjusted OR = 2.09, 95% CI: 2.03-2.15). The TyG index was also strongly associated with fatty liver (adjusted OR = 7.05, 95% CI: 6.82-7.28). Mediation analysis suggested that fatty liver might account for part of the observed association between the TyG index and hypertension, with a proportion statistically accounted for of 23.50% (95% CI: 21.39%-25.96%).
CONCLUSIONS: In this health examination population, a higher TyG index was significantly associated with hypertension, and fatty liver may account for part of the observed association. Further longitudinal studies are needed to clarify these findings.