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)

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • China / epidemiology
  • Glucose
  • Humans
  • Hypertension* / epidemiology
  • Incidence
  • Insulin Resistance*
  • Longitudinal Studies
  • Middle Aged
  • Obesity / epidemiology
  • Retirement
  • Triglycerides

Substances

  • Glucose
  • Triglycerides

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was financially supported by the National Natural Science Foundation of China (No. 82070768), the Natural Science Basic Research Program of Shanxi Province (2021JM-257, 2021JM-588), the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University of China (XJTU1AF-CRF-2022-002 and XJTU1AF2021CRF-021), the Basic-Clinical Integration Innovation Project in Medicine of Xi’an Jiaotong University (YXJLRH2022009), Fundamental Research Funds for the Central Universities (No. xzy012023113), the Institutional Foundation of the First Affiliated Hospital of Xi’an Jiaotong University (2022MS-36 and 2021ZXY-14).