Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website https://www.jofem.org

Original Article

Volume 13, Number 4, November 2023, pages 135-143


Triglyceride Glucose-Waist Circumference Is Superior to Other Biochemical Indicators for Diagnosing Prehypertension and Hypertension

Figure

Figure 1.
Figure 1. The eight anthropometric indicators are represented by receiver-operating characteristic (ROC) curves. Sensitivity refers to the accurate identification of true positives, while 1-specificity denotes the occurrence of false positives. (a) The panel illustrates the curves for prehypertension. (b) The panel displays the curves for hypertension. HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein; WC: waist circumference; BMI: body mass index; TyG: triglyceride-glucose.

Tables

Table 1. Descriptive and Bivariate Characteristics According to the Presence of Prehypertension/Hypertension
 
CharacteristicUndiagnosed prehypertensionUndiagnosed hypertension
No, n = 736Yes, n = 54P valueaNo, n = 788Yes, n = 22P valuea
Data were shown as n (%), and mean (SD). aRao-Scott Chi-square and the F test. *P < 0.05. HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein; TyG: triglyceride-glucose; TyG-WC: TyG-waist circumference; TyG-BMI: TyG-body mass index; SD: standard deviation.
Sex
  Female448 (55.31%)
  Male362 (44.69%)
Age group< 0.001*0.014*
  18 to 29 years old237 (29.26%)230 (97.87%)5 (2.13%)235 (99.16%)2 (0.84%)
  30 to 39 years old214 (26.42%)202 (95.73%)9 (4.27%)210 (98.13%)4 (1.87%)
  40 to 49 years old198 (24.44%)174 (90.62%)18 (9.38%)192 (96.97%)6 (3.03%)
  50 to 59 years old161 (19.88%)130 (85.53%)22 (14.47%)151 (93.79%)10 (6.21%)
Civil status0.2550.354
  Single297 (36.67%)275 (94.50%)16 (5.50%)291 (97.98%)6 (2.02%)
  With couple513 (63.33%)461 (92.38%)38 (7.62%)497 (96.88%)16 (3.12%)
Educational level0.4330.294
  Higher318 (39.41%)291 (92.97%)22 (7.03%)313 (98.43%)5 (1.57%)
  Secondary314 (38.91%)282 (92.16%)24 (7.84%)304 (96.82%)10 (3.18%)
  Until primary175 (21.69%)161 (95.27%)8 (4.73%)169 (96.57%)6 (3.43%)
Natural region0.9670.129
  Jungle118 (14.57%)105 (93.75%)7 (6.25%)111 (94.07%)7 (5.93%)
  Metropolitan Lima383 (47.28%)350 (93.33%)25 (6.67%)375 (97.91%)8 (2.09%)
  Mountain range143 (17.65%)131 (92.25%)11 (7.75%)141 (98.60%)2 (1.40%)
  Rest of coast166 (20.49%)150 (93.17%)11 (6.83%)161 (96.99%)5 (3.01%)
Area of residence0.8480.328
  Rural262 (32.35%)241 (93.41%)17 (6.59%)257 (98.09%)5 (1.91%)
  Urban548 (67.65%)495 (93.05%)37 (6.95%)531 (96.90%)17 (3.10%)
Wealth index0.1260.402
  No poor659 (81.36%)592 (92.50%)48 (7.50%)639 (96.97%)20 (3.03%)
  Poor151 (18.64%)144 (96.00%)6 (4.00%)149 (98.68%)2 (1.32%)
Alcohol consumption0.5600.657
  No406 (50.12%)371 (93.69%)25 (6.31%)396 (97.54%)10 (2.46%)
  Yes404 (49.88%)365 (92.64%)29 (7.36%)3920 (97.03%)12 (2.97%)
Daily smoking0.7550.945
  No701 (86.54%)638 (93.27%)46 (6.73%)682 (97.29%)19 (2.71%)
  Yes109 (13.46%)98 (92.45%)8 (7.55%)106 (97.25%)3 (2.75%)
Physical activity0.7870.978
  High114 (14.07%)104 (93.69%)7 (6.31%)111 (97.37%)3 (2.63%)
  Low537 (66.30%)485 (92.73%)38 (7.27%)522 (97.21%)15 (2.79%)
  Moderate159 (19.63%)147 (94.23%)9 (5.77%)155 (97.48%)4 (2.52%)
Triglycerides/HDL-C ratio5.0 (4.9)4.9 (4.8)7.1 (5.6)0.006*5.0 (4.9)6.4 (4.1)0.131
Cholesterol/HDL-C ratio5.19 (2.03)5.10 (1.98)6.06 (2.14)0.002*5.16 (2.01)6.22 (2.40)0.054
LDL/HDL-C ratio3.22 (1.44)3.17 (1.41)3.65 (1.44)0.021*3.20 (1.42)3.93 (1.82)0.076
Visceral adiposity index2.84 (2.82)2.72 (2.76)4.13 (3.34)0.004*2.82 (2.83)3.72 (2.42)0.100
Lipid accumulation product54 (46)51 (45)79 (57)0.001*53 (46)86 (44)0.002*
TyG index8.84 (0.60)8.80 (0.59)9.10 (0.60)< 0.001*8.82 (0.60)9.28 (0.62)0.003*
TyG-BMI index239 (51)236 (50)265 (48)< 0.001*238 (50)290 (60)< 0.001*
TyG-WC index801 (136)790 (132)889 (133)< 0.001*797 (134)948 (122)< 0.001*

 

Table 2. Multivariable Regression Analysis of Eight Biochemical Indicators Divided Into Tertiles for Prehypertension/Hypertension
 
CharacteristicPrehypertensionHypertension
aORa95% CIP valueaORa95% CIP value
aAdjusted for sex, age group, marital status, educational level, natural region, area of residence, socioeconomic level, alcohol consumption in the last 30 days, current smoker, and physical activity. *P < 0.05. aOR: adjusted odds ratio; CI: confidence interval; Ref: reference; HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein; TyG: triglyceride-glucose; TyG-WC: TyG-waist circumference; TyG-BMI: TyG-body mass index.
Triglycerides/HDL-C ratio
  Tertile 1Ref.Ref.
  Tertile 21.40.59 - 3.470.45210.27 - 4.090.995
  Tertile 32.691.24 - 6.360.017*1.490.45 - 5.850.531
Cholesterol/HDL-C ratio
  Tertile 1Ref.Ref.
  Tertile 21.020.44 - 2.420.9552.050.54 - 9.920.319
  Tertile 32.030.98 - 4.500.0662.140.60 - 10.10.273
LDL/HDL-C ratio
  Tertile 1Ref.Ref.
  Tertile 21.470.67 - 3.360.3441.810.46 - 8.920.419
  Tertile 31.650.77 - 3.700.2082.410.69 - 11.30.202
Visceral adiposity index
  Tertile 1Ref.Ref.
  Tertile 21.440.62 - 3.560.4050.820.21 - 3.470.778
  Tertile 32.481.13 - 5.910.029*1.630.50 - 6.350.439
Lipid accumulation product
  Tertile 1Ref.Ref.
  Tertile 23.191.22 - 9.960.027*1.570.31 - 11.50.606
  Tertile 33.741.45 - 11.70.012*3.730.92 - 25.40.103
TyG index
  Tertile 1Ref.Ref.
  Tertile 21.290.56 - 3.090.5532.10.45 - 14.80.379
  Tertile 32.181.01 - 5.020.0543.590.90 - 24.10.108
TyG-BMI index
  Tertile 1Ref.Ref.
  Tertile 25.031.82 - 17.80.004*1.760.36 - 12.80.512
  Tertile 35.521.99 - 19.70.003*4.391.07 - 30.10.069
TyG-WC index
  Tertile 1Ref.Ref.
  Tertile 25.421.74 - 23.90.009*1.660.19 - 35.20.670
  Tertile 37.602.44 - 33.70.002*9.621.66 - 1860.039*

 

Table 3. Diagnostic Capacity of Each Biochemical Indicator for Prehypertension/Hypertension
 
CutoffsAUCSe (%)Sp (%)PPV (%)NPV (%)LR+ (%)LR- (%)
Se: sensibility; Sp: specificity; PPV: positive predictive value; NPV: negative predictive value; LR+: likelihood ratio positive; LR-: likelihood ratio negative; HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein; TyG: triglyceride-glucose; TyG-WC: TyG-waist circumference; TyG-BMI: TyG-body mass index; AUC: area under the curve.
Prehypertension
  Triglycerides/HDL-C ratio3.950.656 (0.581 - 0.732)68.52 (54.44 - 80.47)58.96 (55.32 - 62.55)10.91 (9.55 - 18.83)96.23 (93.34 - 96.74)1.67 (1.37 - 2.04)0.53 (0.36 - 0.79)
  Cholesterol/HDL-C ratio4.820.649 (0.573 - 0.724)75.92 (62.36 - 86.51)52.71 (49.03 - 56.37)10.54 (9.22 - 19.33)96.76 (94.00 - 97.19)1.61 (1.36 - 1.90)0.45 (0.28 - 0.74)
  LDL/HDL-C ratio3.460.610 (0.534 - 0.685)53.70 (39.61 - 67.38)66.71 (63.18 - 70.11)10.58 (9.20 - 17.41)95.16 (91.74 - 95.81)1.61 (1.23 - 2.11)0.69 (0.52 - 0.93)
  Visceral adiposity index2.350.666 (0.592 - 0.740)66.67 (52.53 - 78.91)62.09 (58.48 - 65.61)11.43 (9.99 - 19.44)96.21 (93.35 - 96-73)1.76 (1.43 - 2.17)0.53 (0.37 - 0.79)
  Lipid accumulation product34.80.678 (0.611 - 0.746)85.19 (72.88 - 93.38)47.28 (43.62 - 50.96)10.59 (9.28 - 22.53)97.75 (95.31 - 98.05)1.61 (1.42 - 1.84)0.31 (0.16 - 0.69)
  TyG index8.940.653 (0.579 - 0.728)66.67 (52.52 - 78.91)61.55 (57.93 - 65.08)11.29 (9.86 - 19.22)96.18 (93.30 - 96-70)1.73 (1.41 - 2.14)0.54 (0.37 - 0.79)
  TyG-BMI index226.20.680 (0.615 - 0.745)85.18 (72.88 - 93.38)46.87 (43.33 - 50.55)10.53 (9.21 - 22.39)97.77 (95.27 - 98.04)1.60 (1.41 - 1.83)0.32 (0.17 - 0.60)
  TyG-WC index762.560.712 (0.650 - 0.775)90.74 (79.70 - 96.92)45.24 (41.61 - 48.92)10.84 (9.49 - 28.11)98.52 (96.29 - 98.72)1.66 (1.49 - 1.84)0.20 (0.09 - 0.47)
Hypertension
  Triglycerides/HDL-C ratio3.890.652 (0.545 - 0.758)77.27 (54.62 - 92.18)55.96 (52.41 - 59.46)4.67 (4.07 - 14.51)98.87 (96.89 - 99.03)1.75 (1.38 - 2.23)0.41 (0.18 - 0.88)
  Cholesterol/HDL-C ratio4.880.651 (0.550 - 0.752)81.82 (59.72 - 94.81)52.66 (49.11 - 56.20)4.60 (4.01 - 16.39)99.04 (97.16 - 99.17)1.73 (1.40 - 2.13)0.34 (0.14 - 0.83)
  LDL/HDL-C ratio3.390.646 (0.547 - 0.744)68.18 (45.23 - 86.14)63.71 (60.24 - 67.07)4.98 (4.33 - 13.20)98.62 (96.49 - 98.81)1.88 (1.39 - 2.54)0.40 (0.27 - 0.92)
  Visceral adiposity index2.320.663 (0.560 - 0.766)72.73 (49.77 - 89.27)59.52 (55.99 - 62.97)4.78 (4.16 - 13.53)98.74 (96.67 - 98.91)1.90 (1.37 - 2.35)0.46 (0.23 - 0.91)
  Lipid accumulation product47.820.743 (0.659 - 0.826)81.81 (59.72 - 94.81)60.41 (56.89 - 63.84)5.45 (4.75 - 18.99)99.17 (97.51 - 99.27)2.07 (1.67 - 2.56)0.30 (0.12 - 0.73)
  TyG index8.830.703 (0.600 - 0.806)81.81 (59.72 - 95.81)54.44 (50.90 - 57.96)4.77 (4.17 - 16.92)99.07 (97.25 - 99.20)1.80 (1.45 - 2.22)0.33 (0.14 - 0.81)
  TyG-BMI index263.070.755 (0.659 - 0.851)68.18 (45.12 - 86.35)71.70 (88.41 - 74.82)6.30 (5.44 - 16.32)98.78 (96.87 - 98.85)2.41 (1.77 - 3.27)0.44 (0.24 - 0.82)
  TyG-WC index862.570.801 (0.718 - 0.883)81.81 (59.72 - 94.81)70.18 (66.84 - 73.35)7.11 (6.16 - 23.73)99.28 (97.85 - 99-38)2.74 (2.19 - 3.43)0.25 (0.11 - 0.63)