The triglycerides and glucose index is associated with elevated blood pressure in apparently healthy children and adolescents
Prevalence of elevated blood pressure in pediatric population has been increasing worldwide. Thus, the aim of this study was to examine whether the triglycerides and glucose (TyG) index is associated with the presence of prehypertension or hypertension in children and adolescents. Apparently healthy children aged 6 to 15 years were enrolled in a population-based cross-sectional study. Participants were allocated into groups with normal blood pressure (NBP), prehypertension, and hypertension. Smoking, alcohol intake, pregnancy, previous diagnosis of diabetes, kidney, hepatic, or endocrine diseases were exclusion criteria. NBP was defined by systolic and/or diastolic blood pressure < 90th percentile, prehypertension by systolic and/or diastolic blood pressure ≥ 90th < 95th percentile, and hypertension by systolic and/or diastolic blood pressure ≥ 95th percentile, according to age, sex, and height percentiles. A total of 3589 children were enrolled, 1748 (49%) girls and 1841 (51%) boys, and allocated into groups with NBP (n = 2874), prehypertension (n = 271), and hypertension (n = 444). The multiple logistic regression analysis stratified by age and adjusted by the Z-score/SDS of body mass index and waist circumference showed that elevated TyG index was significantly associated with prehypertension (OR = 1.48; 95% CI: 1.08–2.05) and hypertension (OR = 1.63; 95% CI: 1.26–2.11).
What is Known:
• Prevalence of elevated blood pressure in children and adolescents has been increasing worldwide.
• Insulin resistance plays a key role in the pathogenesis of hypertension.
What is New:
• The elevated TyG index is significantly associated with the presence of prehypertension in children aged 6–9 years and adolescents aged 10–15 years.
• The elevated TyG index is significantly associated with the presence of hypertension in children aged 6–9 years and adolescents aged 10–15 years.
KeywordsTyG index Triglycerides Glucose Blood pressure Children
triglycerides and glucose
normal blood pressure
Luis E. Simental-Mendía conceptualized and designed the study, drafted the initial manuscript, and approved the final version as submitted. Gabriela Hernández-Ronquillo contributed to conception, critically reviewed the manuscript, and approved the final version as submitted. Claudia I. Gamboa-Gómez contributed to conception, critically reviewed the manuscript, and approved the final version as submitted. Rita Gómez-Díaz contributed to conception, critically reviewed the manuscript, and approved the final version as submitted. Martha Rodríguez-Morán contributed to conception, critically reviewed the manuscript, and approved the final version as submitted. Fernando Guerrero-Romero contributed to conception and study design, drafted the manuscript, critically revised the manuscript, and gave final approval.
No financial assistance was received in support of this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The written informed consent from at least one of each participant’s parents and the informed assent from the participants were obtained.
- 1.Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al (2003) Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure, National Heart, Lung, and Blood Institute, National High Blood Pressure Education Program Coordinating Committee. Seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42:1206–1252CrossRefGoogle Scholar
- 2.de Moraes AC, Carvalho HB, Siani A, Barba G, Veidebaum T, Tornaritis M, Molnar D, Ahrens W, Wirsik N, De Henauw S, Mårild S, Lissner L, Konstabel K, Pitsiladis Y, Moreno LA, IDEFICS consortium (2015) Incidence of high blood pressure in children - effects of physical activity and sedentary behaviors: the IDEFICS study: High blood pressure, lifestyle and children. Int J Cardiol 180:165–170. https://doi.org/10.1016/j.ijcard.2014.11.175 CrossRefGoogle Scholar
- 4.Guerrero-Romero F, Rodríguez-Morán M, Hernández-Ronquillo G, Gómez-Díaz R, Pizano-Zarate ML, Wacher NH, Mondragón-González R, Simental-Mendia LE, Network of Childhood Obesity of the Mexican Social Security Institute (2016) Low serum magnesium levels and its association with high blood pressure in children. J Pediatr. 168:93–98.e1. https://doi.org/10.1016/j.jpeds.2015.09.050
- 11.Mohd Nor NS, Lee S, Bacha F, Tfayli H, Arslanian S (2016) Triglyceride glucose index as a surrogate measure of insulin sensitivity in obese adolescents with normoglycemia, prediabetes, and type 2 diabetes mellitus: comparison with the hyperinsulinemic-euglycemic clamp. Pediatr Diabetes 17(6):458–465. https://doi.org/10.1111/pedi.12303 CrossRefGoogle Scholar
- 13.Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 109(1):45–60CrossRefGoogle Scholar
- 15.Riley M, Bluhm B (2012) High blood pressure in children and adolescents. Am Fam Physician 85(7):693–700Google Scholar
- 17.Sánchez-Íñigo L, Navarro-González D, Pastrana-Delgado J, Fernández-Montero A, Martínez JA (2016) Association of triglycerides and new lipid markers with the incidence of hypertension in a Spanish cohort. J Hypertens 34(7):1257–1265. https://doi.org/10.1097/HJH.0000000000000941 CrossRefGoogle Scholar
- 21.Simental-Mendía LE, Hernández-Ronquillo G, Gómez-Díaz R, Rodríguez-Morán M, Guerrero-Romero F (2017) The triglycerides and glucose index is associated with cardiovascular risk factors in normal-weight children and adolescents. Pediatr Res 82(6):920–925. https://doi.org/10.1038/pr.2017.187 CrossRefGoogle Scholar
- 22.Thackeray JT, Radziuk J, Harper ME, Suuronen EJ, Ascah KJ, Beanlands RS, Dasilva JN (2011) Sympathetic nervous dysregulation in the absence of systolic left ventricular dysfunction in a rat model of insulin resistance with hyperglycemia. Cardiovasc Diabetol 10:75. https://doi.org/10.1186/1475-2840-10-75 CrossRefGoogle Scholar