高血压患者三酰甘油葡萄糖体质量指数与夜间高血压的相关性分析  

Correlation Analysis between TyG-BMI Index and Nocturnal Hypertension in Patients with Hypertension

作　　者：王志军 张士博 刘杰 李东琦 郑美佳 周建芝 WANG Zhijun;ZHANG Shibo;LIU Jie;LI Dongqi;ZHENG Meijia;ZHOU Jianzhi(Department of Cardiology,the Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Department of Internal Medicine,North China University of Science and Technology Hospital,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院心血管内科,河北省唐山市063000 [2]华北理工大学校医院内科,河北省唐山市063000

出　　处：《中国全科医学》2025年第18期2212-2221,共10页Chinese General Practice

基　　金：2024年政府资助临床医学优秀人才培养项目(ZF2024198)。

摘　　要：背景三酰甘油葡萄糖体质量指数(TyG-BMI指数)是反映胰岛素抵抗的一种新型指标,已被证实与高血压存在关联,但目前缺乏TyG-BMI指数与夜间动态血压参数及夜间高血压的研究。目的探讨TyG-BMI指数与夜间动态血压参数及夜间高血压的关系。方法选择2022年6月—2023年10月于华北理工大学附属医院行动态血压监测(ABPM)的原发性高血压患者396例为研究对象,将患者按TyG-BMI指数四分位数分为Q1组(n=99)、Q2组(n=99)、Q3组(n=99)、Q4组(n=99)。收集患者基线资料、实验室检查结果及24 h ABPM结果。计算TyG-BMI指数、三酰甘油葡萄糖(TyG)指数、三酰甘油/高密度脂蛋白胆固醇(TG/HDL-C)。应用广义线性模型分析不同TyG-BMI指数分组与夜间ABPM参数的关联。采用Spearman相关性分析TyG-BMI指数、TyG指数、TG/HDL-C与夜间血压指标相关性。绘制受试者工作特征曲线(ROC曲线)分析TyG-BMI指数对夜间高血压的预测效能并计算ROC曲线下面积(AUC)。结果Q1~Q4组年龄、BMI、TG、空腹血糖(FBG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肾素-血管紧张素-醛固酮系统(RAAS)抑制剂、降脂药、脑卒中、糖尿病、高脂血症比例比较,差异有统计学意义(P<0.05)。Q1~Q4组全天平均收缩压、全天平均舒张压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、夜间收缩压下降率、夜间收缩压标准差、夜间舒张压标准差比较,差异有统计学意义(P<0.05)。广义线性模型结果显示,TyG-BMI指数分组是夜间平均收缩压(β=6.623,P=0.002)、夜间平均舒张压(β=4.553,P=0.001)的影响因素;将研究对象按照是否患有高脂血症或糖尿病进行分层,在未患有高脂血症或糖尿病的研究对象中TyG-BMI指数Q4组是夜间平均舒张压(β=8.462,P<0.001)的影响因素;在患有高脂血症或糖尿病的研究对象中TyG-BMI指数分组与夜间�Background The triglyceride-glucose-BMI(TyG-BMI)index is a novel indicator reflecting insulin resistance and has been proven to be associated with hypertension.However,there 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(ABPM)at 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 index:Q1(n=99),Q2(n=99),Q3(n=99),and Q4(n=99).Baseline data,laboratory test results,and 24-hour ABPM results were collected.The TyG-BMI index,triglyceride-glucose(TyG)index,and triglyceride/high-density lipoprotein cholesterol(TG/HDL-C)ratio 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 index,TyG index,and TG/HDL-C with nocturnal blood pressure indicators.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of the TyG-BMI index for nocturnal hypertension,and the area under the ROC curve(AUC)was calculated.Results There were statistically significant differences in age,BMI,TG,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),use of renin-angiotensin-aldosterone system(RAAS)inhibitors,and proportions of stroke,diabetes,and hyperlipidemia among the Q1 to Q4 groups(P<0.05).Significant differences were also observed in 24-hour average systolic blood pressure,24-hour average diastolic blood pressure,daytime avera

关 键 词：高血压 夜间高血压 三酰甘油葡萄糖体质量指数 风险评估 

分 类 号：R544.1[医药卫生—心血管疾病]