Study Reveals Link Between TyG Index and Heart Failure with Preserved Ejection Fraction in Hypertensive Patients
China: A recent study published in PeerJ revealed a strong connection between insulin resistance (IR), as measured by the triglyceride-glucose (TyG) index, and the onset of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. It emphasizes the important role of metabolic dysfunction in the development of HFpEF, advocating for a more comprehensive approach to cardiovascular risk management.
HFpEF is a common form of heart failure characterized by the inability of the heart to fill properly despite normal ejection fraction levels. It is particularly prevalent among individuals with hypertension and is associated with high morbidity and mortality rates. Traditional risk factors such as hypertension and diabetes have long been recognized, but this study highlights the significance of insulin resistance as a key contributor to the condition.
The triglyceride-glucose index is considered an independent predictor of cardiovascular disease outcomes and a dependable marker of insulin resistance. However, the relationship between the TyG index and heart failure with preserved ejection fraction in patients with essential hypertension has not yet been explored. To fill this knowledge gap, Xue-Feng Shan, Clinical Medical Research Institute, Xinjiang Medical University, Urumqi, China, and colleagues aimed to clarify the potential of the TyG index as a new benchmark for managing this complex clinical condition, facilitating earlier and more targeted interventions.
For this purpose, the researchers conducted a single-center, retrospective study involving patients with essential hypertension at the First Affiliated Hospital of Xinjiang Medical University from December 2018 to September 2020. Participants were chosen based on specific criteria, and their clinical data and lab tests were collected.
The study used Spearman’s correlation analysis, logistic regression models, restricted cubic spline plots, and receiver operating characteristic (ROC) curves to explore the relationship between the TyG index and HFpEF.
The study led to the following findings:
- Out of 1,602 enrolled hypertensive patients, the analysis included 992 patients after applying exclusion criteria. The patients were divided into tertiles based on the TyG index.
- Those in the highest tertile exhibited characteristics linked to a greater risk of heart failure with preserved ejection fraction (HFpEF), such as older age, higher body mass index (BMI), elevated systolic blood pressure (SBP), increased levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and larger left ventricular mass index (LVMI).
- A significant independent association between the TyG index and HFpEF was confirmed, with an odds ratio (OR) of 5.127).
- There was a nonlinear S-shaped relationship between the TyG index and the incidence of HFpEF.
- The predictive abilities for HFpEF were good for the TyG index (AUC: 0.824), NT-proBNP (AUC: 0.840), and LVMI (AUC: 0.847).
- The combination of TyG and LVMI demonstrated the strongest predictive ability (AUC: 0.907).
Reference:
Shan X-F, Yang L, Gao X-M. 2024. Association between triglyceride glycemic index and ejection fraction preserved heart failure in hypertensive patients. PeerJ 12:e18220 DOI 10.7717/peerj.18220
