Association of Triglyceride‐Glucose Index, Triglyceride/HDL Cholesterol Ratio and Metabolic Score for Insulin Resistance With Asymptomatic Organ Damage in Previously Untreated Patients With Hypertension

ABSTRACT

We aimed to examine the association between insulin resistance (IR) and target organ damage (TOD) in patients with hypertension. Three indices of IR (Triglyceride‐Glucose index: TyG; triglyceride‐to‐HDL ratio: TG/HDL‐C; Metabolic Score for Insulin Resistance: METS‐IR) were examined for their association with TOD in 614 newly diagnosed patients with hypertension. Left ventricular mass index (LVMI), the intima‐media thickness of the common carotid artery (IMT‐CCA) and estimated Glomerular Filtration Rate (eGFR) were used as indices of cardiac, artery and renal damage. Receiver Operating Characteristic (ROC) analysis performed to estimate optimal cut‐off for each index, while simple and multiple logistic regression models were applied to examine the indices as binary predictors of organ damage. Linear and non‐linear associations were examined with continuous variables using linear regression and restricted cubic splines (RCS) models. After adjusting for confounders, logistic regression showed that high TG/HDL‐C (OR:1.50, 95%CI:1.03–2.18) and METS‐IR (OR:2.17, 95%CI:1.50–3.13) were associated with increased risk of left ventricular hypertrophy, while only high METS‐IR was associated with increased risk of carotid plaque (OR:2.07, 95%CI:1.17–3.68) and only high TG/HDL‐C was associated with renal damage (OR:2.33, 95%CI:1.02–5.36). Adjusted linear regression showed that none of the indices were significantly associated with LVMI. However, all indices were associated with CCA‐IMT ( p  < 0.05), but none with eGFR ( p  > 0.05). Adjusted RCS models showed a significant non‐linear association between TyG and CCA‐IMT ( p for non‐linearity = 0.009). In conclusion, IR biomarkers are of clinical value in newly diagnosed patients with hypertension.