甘油三酯-葡萄糖-体质量指数与18～45岁人群高血压的关联及最佳临界值研究OA
Association between triglyceride glucose-body mass index and hypertension and its optimal cut-off value in adults aged 18 to 45 years
目的 探讨甘油三酯-葡萄糖-体质量指数(TyG-BMI)与18～45岁人群高血压患病状态的关联及最佳临界值,为体检人群高血压风险筛查提供参考.方法 回顾性纳入2024年在江苏省苏北人民医院体检的18～45岁体检人员7 851例,采用Logistic回归、限制性立方样条及受试者工作特征(ROC)曲线评价TyG-BMI与高血压患病状态的关联及其判别效能,并按最佳临界值进行风险分组.使用Dryad公开数据库的日本独立队列进行外部验证,采用ROC曲线的曲线下面积(AUC)和决策曲线分析评价模型的判别效能及潜在临床实用性.结果 TyG-BMI对高血压的判别效能优于甘油三酯-葡萄糖指数(TyG),二者AUC分别为0.775和0.728;TyG-BMI的最佳临界值为216.54,约登指数为0.422,敏感度为68.2％,特异度为74.0％.校正混杂因素后,TyG-BMI高危状态仍为18～45岁人群高血压患病的独立危险因素(OR=2.363,95％CI:1.955～2.855,P＜0.001).在日本队列外部验证中,TyG-BMI仍显示出较好的判别效能(AUC为0.812);决策曲线分析显示,在0.05～0.25阈值概率范围内,TyG-BMI模型具有相对较高的净获益.结论 TyG-BMI与18～45岁人群高血压患病状态密切相关,且判别效能优于单一 TyG指标,外部验证结果提示该复合指标可能为东亚地区体检人群高血压风险筛查提供参考.
Objective To investigate the association between triglyceride glucose-body mass in-dex(TyG-BMI)and hypertension status in adults aged 18 to 45 years,and to determine its optimal cut-off value,thereby providing a reference for hypertension risk screening in health check-up popula-tions.Methods A total of 7851 health check-up participants aged 18 to 45 years who underwent physical examination at Northern Jiangsu People's Hospital in 2024 were retrospectively enrolled.Logistic regression,restricted cubic spline analysis,and receiver operating characteristic(ROC)curve analysis were used to evaluate the association between TyG-BMI and hypertension status and its dis-criminatory performance,and risk stratification was performed based on the optimal cut-off value.An independent Japanese cohort from the Dryad open database was used for external validation.The area under the ROC curve(AUC)and decision curve analysis were used to evaluate the discriminatory per-formance and potential clinical utility of the model.Results TyG-BMI demonstrated better discriminatory performance for hypertension than the triglyceride-glucose(TyG)index,with AUC of 0.775 and 0.728,respectively.The optimal cut-off value for TyG-BMI was 216.54,with a Youden index of 0.422,a sensitivity of 68.2％,and a specificity of 74.0％.After adjusting for confounders,high-risk TyG-BMI status remained an independent risk factor for hypertension in adults aged 18 to 45 years(OR=2.363,95％CI,1.955 to 2.855,P＜0.001).In the external validation using the Japanese cohort,TyG-BMI continued to show good discriminatory performance(AUC=0.812).Decision curve analysis revealed that the TyG-BMI model provided a relatively high net benefit with-in a threshold probability range of 0.05 to 0.25.Conclusion TyG-BMI is closely associated with hypertension status in adults aged 18 to 45 years,and its discriminatory performance is superior to that of the TyG index alone.External validation results suggest that this composite index may provide a reference for hypertension risk screening in East Asian health check-up populations.
梁悦英;李倩;朱业
扬州大学医学部,江苏扬州,225000扬州大学医学部,江苏扬州,225000扬州大学医学部,江苏扬州,225000||扬州大学附属苏北人民医院心内科,江苏扬州,225000
医药卫生
甘油三酯-葡萄糖-体质量指数高血压胰岛素抵抗受试者工作特征曲线决策曲线分析限制性立方样条最佳临界值
triglyceride glucose-body mass indexhypertensioninsulin resistancereceiver operating characteristic curvedecision curve analysisrestricted cubic splineoptimal cut-off value
《实用临床医药杂志》 2026 (17)
54-62,9
国家自然科学基金项目(81800250)中国博士后科学基金(2022M711417)江苏省中医药科技发展计划(MS2023137)
评论