Abstract
The triglyceride to high-density lipoprotein-cholesterol (TG/HDL-C) ratio is considered a simple surrogate of insulin resistance. The aim of this study was to explore the association of the TG/HDL-C ratio with the risk of incident hypertension and whether the TG/HDL-C ratio mediates the obesity–incident hypertension association. The study analyzed 9679 participants from a rural Chinese population. Demographic and anthropometric and laboratory data were collected at baseline (2007–2008) and follow-up (2013–2014) examinations. A multivariate logistic regression model was used to analyze the association of the TG/HDL-C ratio with incident hypertension, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Mediation analysis was performed to examine the contribution of the TG/HDL-C ratio to obesity-related incident hypertension. During a median follow-up of 6.00 years, hypertension developed in 1880/9679 participants (19.42%). The risk of incident hypertension was higher in the highest TG/HDL-C ratio quartile than in the lowest quartile (OR = 1.21, 95% CI = 1.02–1.42). Subgroup analyses showed that the risk of incident hypertension was increased by 30%, 36%, and 33% among women, participants < 60 years old and those with prehypertension at baseline, respectively. The TG/HDL-C ratio partially mediated the obesity–incident hypertension association (indirect effect: OR = 1.04, 95% CI: 1.01–1.07; direct effect: OR = 1.36, 95% CI: 1.16–1.62). The TG/HDL-C ratio may be a risk factor for incident hypertension, especially in women, participants < 60 years old and those with prehypertension. The TG/HDL-C ratio may also play a mediating role in obesity-related incident hypertension.
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Acknowledgements
DL, JL, and DH substantially contributed to the design and drafting of the study and the analysis and interpretation of the data. LG, YZ, YL, XS, HL, ZY, LiL, YR, BW, CC, LeL, XC, QZ, QL, CG, GT, and MZ revised the paper critically for important intellectual content. The investigators are grateful to the dedicated participants and all research staff involved in the study. All authors were involved in the collection of data and approved the final version of the paper.
Funding
This study was supported by the National Natural Science Foundation of China (grant nos. 81373074, 81402752, and 81673260) and the Natural Science Foundation of Guangdong Province (grant no. 2017A030313452).
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Liu, D., Guan, L., Zhao, Y. et al. Association of triglycerides to high-density lipoprotein-cholesterol ratio with risk of incident hypertension. Hypertens Res 43, 948–955 (2020). https://doi.org/10.1038/s41440-020-0439-8
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DOI: https://doi.org/10.1038/s41440-020-0439-8
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