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. 2024 Feb 13:12:1320918.
doi: 10.3389/fpubh.2024.1320918. eCollection 2024.

The effect of insulin resistance in the association between obesity and hypertension incidence among Chinese middle-aged and older adults: data from China health and retirement longitudinal study (CHARLS)

Ze-Jiaxin Niu  1   2 , Ying Cui  3 , Tian Wei  2 , Meng Dou  2 , Bing-Xuan Zheng  2 , Ge Deng  2 , Pu-Xun Tian  2 , Yang Wang  1   4
Affiliations

The effect of insulin resistance in the association between obesity and hypertension incidence among Chinese middle-aged and older adults: data from China health and retirement longitudinal study (CHARLS)

Ze-Jiaxin Niu et al. Front Public Health. .

Abstract

Background and aims: Obesity and insulin resistance are well-known important risk factors for hypertension. This study aimed to investigate the mediating effect of the triglyceride-glucose index (TyG) in the association between Chinese visceral obesity index (CVAI) and hypertension among Chinese middle-aged and older adults.

Methods: A total of 10,322 participants aged 45 years and older from CHARLS (2011-2018) were included. Baseline data were collected in 2011 and hypertension incidence data were gathered during follow-up in 2013, 2015 and 2018. Multivariate logistic regression models were constructed to investigate the association of CVAI and TyG with the incidence of hypertension. Additionally, mediation analyses were conducted to evaluate the mediating role of the TyG index in the relationship between CVAI and hypertension. Subgroup analysis was also performed.

Results: A total of 2,802 participants developed hypertension during the follow-up period. CVAI and TyG index were independently and significantly associated with hypertension incidence. Increasing quartiles of CVAI and TyG index were associated with high hypertension incidence in middle-aged and older adults. The TyG index was identified as a mediator in the relationship between CVAI and hypertension incidence, with a mediation effect (95% confidence interval) was 12.38% (6.75, 31.81%).

Conclusion: Our study found that CVAI and TyG were independently associated with hypertension incidence. TyG played a partial mediating effect in the positive association between CVAI and hypertension incidence.

Keywords: China health and retirement longitudinal study; hypertension; insulin resistance; mediation effects; obesity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for participants’ selection. The 2011 baseline survey accumulated 17,705 respondents, and subjects missing blood samples or biological data (n = 14), aged below 45 years (n = 366), hypertensive in 2011 (n = 4,267) and lost in follow-up (n = 2,736) were excluded.
Figure 2
Figure 2
Mediation effect of TyG in the associations between CVAI and hypertension incidence using the general mediation model. The regression coefficient β1 represented the effect of CVAI on TyG index, the regression coefficient β2 represented the effect of TyG on hypertension incidence, βlnd (indirect effect) was calculated as β1 × β2, c’ signified the direct effect of CVAI on hypertension, and C represented the total effect of CVAI on hypertension (the sum of the direct and indirect effects). **p < 0.001,*p < 0.05.
Figure 3
Figure 3
Association of the CVAI and TyG index and hypertension incidence in different subgroups. Multivariate logistic regression models were adjusted for age, sex, marital status, education level, SBP current smoking and alcohol consumption. OR, odds ratio; CI, confidence interval; CVAI, Chinese visceral adiposity index; TyG, triglyceride glucose index.
See this image and copyright information in PMC

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