Association of Triglyceride-Glucose Body Mass Index with Target Organ Damage in Essential Hypertension: A Retrospective Cohort Study

Abstract

The triglyceride-glucose body mass index (TyG-BMI) is an emerging composite metabolic indicator in cardiovascular research. However, the link between TyG-BMI and target organ damage (TOD) in essential hypertension (EH) remains uncertain. This study investigated the association between TyG-BMI and TOD in patients with EH. We conducted a retrospective cohort study involving 493 individuals with EH. Participants were divided at the cohort-specific median into high and low TyG-BMI groups. Over a median follow-up of 23 months, 191 participants experienced TOD. Kaplan-Meier curves showed a significantly higher cumulative incidence of TOD in the high TyG-BMI group than in the low TyG-BMI group (p < 0.05). In multivariable logistic regression, TyG-BMI remained an independent correlate of TOD (adjusted OR = 1.83, 95% CI: 1.08-3.10; p < 0.05). Least absolute shrinkage and selection operator-Cox regression further selected TyG-BMI, age, and smoking status as key predictors of TOD. Subgroup analyses revealed that the TyG-BMI-TOD association was stronger among younger or middle-aged, normal-weight, non-diabetic, non-smoking subjects (p < 0.05). Finally, the TyG-BMI-based model achieved predictive accuracy comparable to that of a conventional risk-factor model. In conclusion, TyG-BMI is independently associated with TOD in EH patients. Its predictive value closely mirrors that of combined traditional risk factors, highlighting TyG-BMI as a promising clinical marker.

Keywords: hypertension; insulin resistance; target organ damage; triglyceride–glucose body mass index.

FIGURE 1

Flow diagram of participant inclusion and stratification. EH, essential hypertension; TOD, target organ damage; TyG‐BMI, triglyceride–glucose body mass index.

FIGURE 2

Kaplan–Meier curves for TOD‐free survival stratified by TyG‐BMI. TOD, target organ damage; TyG‐BMI, triglyceride–glucose body mass index.

FIGURE 3

Multivariable selection and subgroup effects for the TyG‐BMI–TOD association. (A) Cross‐validated LASSO‐Cox identifies independent predictors of TOD. (B) Forest plot of hazard ratios for high versus low TyG‐BMI across prespecified subgroups. BMI, body mass index; CI, confidence interval; HR, hazard ratio; LASSO, least absolute shrinkage and selection operator; TOD, target organ damage; TyG‐BMI, triglyceride–glucose body mass index.

FIGURE 4

Restricted cubic spline illustrating the nonlinear association between TyG‐BMI and target organ damage. CI, confidence interval; TyG‐BMI, triglyceride–glucose body mass index.

FIGURE 5

TyG‐BMI–based model for predicting TOD in essential hypertension. (A) Nomogram derived from LASSO‐Cox selected variables. (B) Calibration plot comparing predicted and observed 1‐, 3‐, and 5‐year risks. (C–E) Time‐dependent ROC curves at 1, 3, and 5 years. (F–H) DCA contrasting the TyG‐BMI model with a traditional risk factor model. AUC, area under the curve; CI, confidence interval; DCA, decision curve analysis; ROC, receiver operating characteristic; TOD, target organ damage; TyG‐BMI, triglyceride–glucose body mass index.