Comparison of seven anthropometric indexes to predict hypertension plus hyperuricemia among U.S. adults

Abstract

Purpose: This study aims to compare the association of hypertension plus hyperuricemia (HTN-HUA) with seven anthropometric indexes. These include the atherogenic index of plasma (AIP), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), body roundness index (BRI), a body shape index (ABSI), and the cardiometabolic index (CMI).

Methods: Data was procured from the National Health and Nutrition Examination Survey (NHANES), which recruited a representative population aged 18 years and above to calculate these seven indexes. Logistic regression analysis was employed to delineate their correlation and to compute the odds ratios (OR). Concurrently, receiver operating characteristic (ROC) curves were utilized to evaluate the predictive power of the seven indexes.

Results: A total of 23,478 subjects were included in the study. Among these, 6,537 (27.84%) were patients with HUA alone, 2,015 (8.58%) had HTN alone, and 2,836 (12.08%) had HTN-HUA. The multivariate logistic regression analysis showed that the AIP, LAP, VAI, TyG, BRI, ABSI, and CMI were all significantly associated with concurrent HTN-HUA. The OR for the highest quartile of the seven indexes for HTN-HUA were as follows: AIP was 4.45 (95% CI 3.82-5.18), LAP was 9.52 (95% CI 7.82-11.59), VAI was 4.53 (95% CI 38.9-5.28), TyG was 4.91 (95% CI 4.15-5.80), BRI was 9.08 (95% CI 7.45-11.07), ABSI was 1.71 (95% CI 1.45 -2.02), and CMI was 6.57 (95% CI 5.56-7.76). Notably, LAP and BRI demonstrated significant discriminatory abilities for HTN-HUA, with area under the curve (AUC) values of 0.72 (95% CI 0.71 - 0.73) and 0.73 (95% CI 0.72 - 0.74) respectively.

Conclusion: The AIP, LAP, VAI, TyG, BRI, ABSI, and CMI all show significant correlation with HTN-HUA. Notably, both LAP and BRI demonstrate the capability to differentiate cases of HTN-HUA. Among these, BRI is underscored for its effective, non-invasive nature in predicting HTN-HUA, making it a superior choice for early detection and management strategies.

Keywords: NHANES (National Health and Nutrition Examination Survey); adults (MeSH); anthropometric indexes; hypertension; hyperuricemia.

Figure 1

Flowchart of the study. *The covariates include age, gender, race/ethnicity, education level, PIR, smoking, alcohol consumption, MET, SBP, DBP, FPG, HbA1c, creatinine, urea nitrogen, TC, LDL-C, eGFR, hypoglycemic drugs, and lipid-lowering drugs. AIP, atherogenic index of plasma; LAP, lipid accumulation product; VAI, visceral adiposity index; TyG, triglyceride-glucose index; BRI, body roundness index; ABSI, a body shape index; CMI, cardiometabolic index; PIR, poverty income ratio; MET, metabolic equivalent of task; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HbA1c, glycated hemoglobin; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate.

Figure 2

Atherogenic index of plasma (A), lipid accumulation product (B), visceral adiposity index (C), triglyceride-glucose index (D), body roundness index (E), a body shape index (F), cardiometabolic index (G) values in different groups. Group C refers to participants who have neither hypertension nor hyperuricemia. HTN, hypertension alone; HUA, hyperuricemia alone; HTN-HUA, hypertension plus hyperuricemia; AIP, atherogenic index of plasma; LAP, lipid accumulation product; VAI, visceral adiposity index; TyG, triglyceride-glucose index; BRI, body roundness index; ABSI, a body shape index; CMI, cardiometabolic index.

Figure 3

Receiver operating characteristic curves of seven anthropometric indexes for prediction of (A) hypertension alone; (B) hyperuricemia alone; and (C) hypertension plus hyperuricemia. ABSI, a body shape index; BRI, body roundness index; LAP, lipid accumulation product; TyG, triglyceride-glucose index; CMI, cardiometabolic index; VAI, visceral adiposity index; AIP, atherogenic index of plasma.