Associations of triglyceride-glucose index and metabolic score for insulin resistance with various hypertension phenotypes in children and adolescents: results from the 2017 China nutrition and health surveillance.
Level 4 - case-series / case-control
Cross-sectional observational study
PubMed 40778272 · doi:10.3389/fendo.2025.1595097
What was done
Researchers evaluated the cross-sectional association between surrogate markers of insulin resistance—the triglyceride-glucose index (TyG) and the metabolic score for insulin resistance (METS-IR)—and hypertension phenotypes among 12,087 children and adolescents (aged 7–17 years) from the 2017 China National Nutrition and Health Surveillance. Blood pressure was categorized based on age-, sex-, and height-specific ≥95th percentiles into isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). Associations were evaluated using multivariable logistic regression and restricted cubic splines.
What was found
After multivariable adjustment, both TyG and METS-IR showed positive linear relationships with all hypertension phenotypes (p-nonlinearity > 0.10): - Per 1-unit increase in TyG: ISH odds increased by 44% (OR 1.44, 95% CI 1.31–1.59), IDH by 47% (OR 1.47, 95% CI 1.21–1.79), and SDH by 61% (OR 1.61, 95% CI 1.35–1.91). - Per 1-unit increase in METS-IR: ISH odds increased by 10% (OR 1.10, 95% CI 1.09–1.12), IDH by 6% (OR 1.06, 95% CI 1.03–1.08), and SDH by 12% (OR 1.12, 95% CI 1.10–1.14). - Subgroup analyses remained consistent for ISH and SDH, but the association with IDH lost statistical significance in certain subsets, including participants aged ≥12 years, those with sufficient sleep, and those reporting daily exercise.
Why it matters
TyG and METS-IR are accessible, low-cost markers of insulin resistance that may assist in identifying pediatric patients at higher risk for specific blood pressure phenotypes before overt cardiovascular disease manifests.
Limits
The cross-sectional design cannot establish temporality or causality between insulin resistance markers and elevated blood pressure. The study is restricted to a Chinese pediatric population, limiting direct generalizability to other demographic groups. Blood pressure was assessed within a survey context without ambulatory monitoring confirmation, and residual confounding from unmeasured lifestyle or dietary factors remains possible.
Cited by
- partial High diastolic blood pressure is primarily driven by insulin resistance.