高血压患者甘油三酯-葡萄糖体质量指数与夜间高血压的相关性分析

Background??The triglyceride-glucose-body mass indexTyG-BMI indexis a novel indicator reflecting insulin resistance and has been proven to be associated with hypertension. Howeverthere is a lack of research on the relationship between the TyG-BMI index and nocturnal ambulatory blood pressure parameters as well as nocturnal hypertension. Objective ?To explore the relationship between the TyG-BMI index and nocturnal ambulatory blood pressure parameters as well as nocturnal hypertension. Methods ?A total of 396 patients with essential hypertension who underwent ambulatory blood pressure monitoring ABPMat the Affiliated Hospital of North China University of Science and Technology from June 2022 to October 2023 were selected as the study subjects. Patients were divided into four groups based on the quartiles of the TyG-BMI indexQ1n=99Q2n=99Q3n=99and Q4n=99. Baseline datalaboratory test resultsand 24-hour ABPM results were collected. The TyG-BMI indextriglyceride-glucoseTyGindexand triglyceride/high-density lipoprotein cholesterolTG/ HDL-Cratio were calculated. A generalized linear model was used to analyze the association between different TyG-BMI index groups and nocturnal ABPM parameters. Spearman correlation analysis was employed to assess the correlations of the TyG-BMI indexTyG indexand TG/HDL-C with nocturnal blood pressure indicators. Receiver operating characteristicROCcurves were plotted to analyze the predictive efficacy of the TyG-BMI index for nocturnal hypertensionand the area under the ROC curveAUCwas calculated. Results ?There were statistically significant differences in ageBMIfasting TGfasting blood glucoseFBGuse of renin-angiotensin-aldosterone systemRAASinhibitorsand proportions of strokediabetesand hyperlipidemia among the Q1 to Q4 groupsP<0.05. Significant differences were also observed in 24-hour average systolic blood pressure24-hour average diastolic blood pressuredaytime average systolic blood pressuredaytime average diastolic blood pressurenocturnal average systolic blood pressurenocturnal average diastolic blood pressurenocturnal systolic blood pressure dipnocturnal systolic blood pressure standard deviationand nocturnal diastolic blood pressure standard deviation among these groupsP<0.05. The results of the generalized linear model indicated that the TyG-BMI index group was a significant influencer of nocturnal average systolic blood pressure=6.623P=0.002and nocturnal average diastolic blood pressure=4.553P=0.001. When stratified by the presence of hyperlipidemia or diabetesthe TyG-BMI index group was found to be a significant influencer of nocturnal average diastolic blood pressure=8.462P<0.001in subjects without hyperlipidemia or diabetesbut no correlation was observed between the TyG-BMI index group and nocturnal average systolic blood pressure=4.604P=0.097or nocturnal average diastolic blood pressure=1.988P=0.285in subjects with hyperlipidemia or diabetes. Spearman correlation analysis revealed a positive correlation between the TyG-BMI index and nocturnal average systolic blood pressurers=0.155P=0.002in hypertensive patientsand positive correlations between TG/HDL-Crs=0.193P<0.001TyG indexrs=0.145P=0.004TyG-BMI indexrs=0.250P<0.001and nocturnal average diastolic blood pressure. ROC curves were plotted for TG/HDL-CTyG indexand TyG-BMI index to predict nocturnal hypertensionwith AUCs of 0.57095%CI=0.513-0.627P=0.0170.55995%CI=0.502-0.616P=0.046and 0.61895%CI=0.563-0.673P<0.001respectively. In subjects with hyperlipidemia or diabetesthe AUCs for TG/HDL-C and TyG-BMI index predicting nocturnal hypertension were 0.57895%CI=0.504-0.651P=0.043and 0.62795%CI=0.557-0.698P=0.001respectively. Conclusion ?In patients with essential hypertensionthe TyG-BMI index is positively correlated with nocturnal average diastolic blood pressure. The TyG-BMI index has a high predictive value for nocturnal hypertension.