Triglyceride glucose-body mass index as a mediator of hypertension risk in obstructive sleep apnoea syndrome: a mediation analysis study.
Hypertension
Insulin resistance
Obstructive sleep apnoea syndrome (OSAS)
Triglyceride glucose-body mass index (TyG-BMI)
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
29 10 2024
29 10 2024
Historique:
received:
26
05
2024
accepted:
14
10
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
The aim of this study was to investigate whether triglyceride glucose-body mass index (TyG-BMI) plays a mediating role between obstructive sleep apnoea syndrome (OSAS) and hypertension. The study analyzed clinical data from a total of 840 OSAS patients at Wuhan Union Hospital between January 2020 to December 2023. The association between TyG-BMI and hypertension was examined using restricted cubic spline regression and logistic regression. Mediation effect analysis was conducted to explore the relationship between OSAS, TyG-BMI, and the risk of hypertension. Severe OSAS was associated with a significantly increased risk of hypertension compared to mild OSAS (OR = 1.752, p = 0.013). There was a positive linear relationship between TyG-BMI and the risk of hypertension (P-non-linear = 0.535). The risk of hypertension increased with increasing TyG-BMI, with a significantly higher risk of hypertension in the fourth quartile (OR = 3.407, p < 0.001) than in the third quartile (OR = 2.457, p < 0.001) and in the second quartile (OR = 1.576, p = 0.043). TyG-BMI mediated the association between OSAS and hypertension with a mediation effect of 41.3% (p < 0.001). TyG-BMI is important for assessing the risk of hypertension in patients with OSAS.
Identifiants
pubmed: 39472609
doi: 10.1038/s41598-024-76378-x
pii: 10.1038/s41598-024-76378-x
doi:
Substances chimiques
Triglycerides
0
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
25910Informations de copyright
© 2024. The Author(s).
Références
Lv, R. et al. Pathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome. Signal Transduct. Target Ther. 8, 218. https://doi.org/10.1038/s41392-023-01496-3 (2023).
doi: 10.1038/s41392-023-01496-3
pubmed: 37230968
pmcid: 10211313
Heinzer, R. et al. Prevalence of sleep-disordered breathing in the general population: The HypnoLaus study. Lancet Respir. Med. 3, 310–318. https://doi.org/10.1016/s2213-2600(15)00043-0 (2015).
doi: 10.1016/s2213-2600(15)00043-0
pubmed: 25682233
pmcid: 4404207
Lévy, P. et al. Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers 1, 15015. https://doi.org/10.1038/nrdp.2015.15 (2015).
doi: 10.1038/nrdp.2015.15
pubmed: 27188535
Somers, V. K. et al. Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. J. Am. Coll. Cardiol. 52, 686–717. https://doi.org/10.1016/j.jacc.2008.05.002 (2008).
doi: 10.1016/j.jacc.2008.05.002
pubmed: 18702977
Redline, S., Azarbarzin, A. & Peker, Y. Obstructive sleep apnoea heterogeneity and cardiovascular disease. Nat. Rev. Cardiol. 20, 560–573. https://doi.org/10.1038/s41569-023-00846-6 (2023).
doi: 10.1038/s41569-023-00846-6
pubmed: 36899115
Yaggi, H. K. et al. Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med. 353, 2034–2041. https://doi.org/10.1056/NEJMoa043104 (2005).
doi: 10.1056/NEJMoa043104
pubmed: 16282178
Peppard, P. E., Young, T., Palta, M. & Skatrud, J. Prospective study of the association between sleep-disordered breathing and hypertension. N. Engl. J. Med. 342, 1378–1384. https://doi.org/10.1056/nejm200005113421901 (2000).
doi: 10.1056/nejm200005113421901
pubmed: 10805822
Schein, A. S., Kerkhoff, A. C., Coronel, C. C., Plentz, R. D. & Sbruzzi, G. Continuous positive airway pressure reduces blood pressure in patients with obstructive sleep apnea; A systematic review and meta-analysis with 1000 patients. J. Hypertens. 32, 1762–1773. https://doi.org/10.1097/hjh.0000000000000250 (2014).
doi: 10.1097/hjh.0000000000000250
pubmed: 24979300
Ota, H. et al. Relationship between intermittent hypoxia and type 2 diabetes in sleep apnea syndrome. Int. J. Mol. Sci. 20, https://doi.org/10.3390/ijms20194756 (2019).
Martínez Cerón, E., Casitas Mateos, R. & García-Río, F. Sleep apnea-hypopnea syndrome and type 2 diabetes. A reciprocal relationship?. Arch. Bronconeumol. 51, 128–139 (2015).
doi: 10.1016/j.arbres.2014.06.017
pubmed: 25145320
da Silva, A. A. et al. Role of hyperinsulinemia and insulin resistance in hypertension: Metabolic syndrome revisited. Can. J. Cardiol. 36, 671–682. https://doi.org/10.1016/j.cjca.2020.02.066 (2020).
doi: 10.1016/j.cjca.2020.02.066
pubmed: 32389340
da Silva, A. et al. Triglyceride-glucose index is associated with symptomatic coronary artery disease in patients in secondary care. Cardiovasc. Diabetol. 18, 89. https://doi.org/10.1186/s12933-019-0893-2 (2019).
doi: 10.1186/s12933-019-0893-2
pubmed: 31296225
pmcid: 6625050
Lim, J., Kim, J., Koo, S. H. & Kwon, G. C. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007–2010 Korean National Health and Nutrition Examination Survey. PLoS One 14, e0212963. https://doi.org/10.1371/journal.pone.0212963 (2019).
doi: 10.1371/journal.pone.0212963
pubmed: 30845237
pmcid: 6405083
Er, L. K. et al. Triglyceride glucose-body mass index is a simple and clinically useful surrogate marker for insulin resistance in nondiabetic individuals. PLoS One 11, e0149731. https://doi.org/10.1371/journal.pone.0149731 (2016).
doi: 10.1371/journal.pone.0149731
pubmed: 26930652
pmcid: 4773118
Li, Y. et al. Insulin resistance surrogates predict hypertension plus hyperuricemia. J. Diabetes Investig. 12, 2046–2053. https://doi.org/10.1111/jdi.13573 (2021).
doi: 10.1111/jdi.13573
pubmed: 33982885
pmcid: 8565421
Qaseem, A. et al. Management of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians. Ann. Intern. Med. 159, 471–483. https://doi.org/10.7326/0003-4819-159-7-201310010-00704 (2013).
doi: 10.7326/0003-4819-159-7-201310010-00704
pubmed: 24061345
Sateia, M. J. International classification of sleep disorders-third edition: Highlights and modifications. Chest 146, 1387–1394. https://doi.org/10.1378/chest.14-0970 (2014).
doi: 10.1378/chest.14-0970
pubmed: 25367475
Mancia, G. et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J. Hypertens. 41, 1874–2071. https://doi.org/10.1097/hjh.0000000000003480 (2023).
doi: 10.1097/hjh.0000000000003480
pubmed: 37345492
Lux, D. et al. The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke. J. Neuroinflamm. 17, 60. https://doi.org/10.1186/s12974-020-01739-y (2020).
doi: 10.1186/s12974-020-01739-y
Sanders, M. H. Article reviewed: Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Med. 1, 327–328. https://doi.org/10.1016/s1389-9457(00)00060-5 (2000).
doi: 10.1016/s1389-9457(00)00060-5
pubmed: 11040469
Ryan, S. et al. Adipose tissue as a key player in obstructive sleep apnoea. Eur. Respir. Rev. 28, https://doi.org/10.1183/16000617.0006-2019 (2019).
Thorn, C. E. et al. Adipose tissue is influenced by hypoxia of obstructive sleep apnea syndrome independent of obesity. Diabetes Metab. 43, 240–247. https://doi.org/10.1016/j.diabet.2016.12.002 (2017).
doi: 10.1016/j.diabet.2016.12.002
pubmed: 28131740
Briançon-Marjollet, A. et al. Intermittent hypoxia in obese Zucker rats: Cardiometabolic and inflammatory effects. Exp. Physiol. 101, 1432–1442. https://doi.org/10.1113/ep085783 (2016).
doi: 10.1113/ep085783
pubmed: 27615447
Uchiyama, T. et al. Up-regulation of selenoprotein P and HIP/PAP mRNAs in hepatocytes by intermittent hypoxia via down-regulation of miR-203. Biochem. Biophys. Rep. 11, 130–137. https://doi.org/10.1016/j.bbrep.2017.07.005 (2017).
doi: 10.1016/j.bbrep.2017.07.005
pubmed: 28955777
pmcid: 5614699
Takasawa, S. et al. Upregulation of IL-8, osteonectin, and myonectin mRNAs by intermittent hypoxia via OCT1- and NRF2-mediated mechanisms in skeletal muscle cells. J. Cell Mol. Med. 26, 6019–6031. https://doi.org/10.1111/jcmm.17618 (2022).
doi: 10.1111/jcmm.17618
pubmed: 36457269
pmcid: 9753449
Sasaki, N. et al. Adipose tissue insulin resistance predicts the incidence of hypertension: The Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases. Hypertens. Res. 45, 1763–1771. https://doi.org/10.1038/s41440-022-00987-0 (2022).
doi: 10.1038/s41440-022-00987-0
pubmed: 35948666
Sung, K. C., Lim, S. & Rosenson, R. S. Hyperinsulinemia and homeostasis model assessment of insulin resistance as predictors of hypertension: A 5-year follow-up study of Korean sample. Am. J. Hypertens. 24, 1041–1045. https://doi.org/10.1038/ajh.2011.89 (2011).
doi: 10.1038/ajh.2011.89
pubmed: 21614095
Reaven, G. M., Lithell, H. & Landsberg, L. Hypertension and associated metabolic abnormalities–the role of insulin resistance and the sympathoadrenal system. N. Engl. J. Med. 334, 374–381. https://doi.org/10.1056/nejm199602083340607 (1996).
doi: 10.1056/nejm199602083340607
pubmed: 8538710
Jia, G. & Sowers, J. R. Hypertension in diabetes: An update of basic mechanisms and clinical disease. Hypertension 78, 1197–1205. https://doi.org/10.1161/hypertensionaha.121.17981 (2021).
doi: 10.1161/hypertensionaha.121.17981
pubmed: 34601960
Hill, M. A. et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Metabolism 119, 154766. https://doi.org/10.1016/j.metabol.2021.154766 (2021).
doi: 10.1016/j.metabol.2021.154766
pubmed: 33766485
Alizargar, J., Bai, C. H., Hsieh, N. C. & Wu, S. V. Use of the triglyceride-glucose index (TyG) in cardiovascular disease patients. Cardiovasc. Diabetol. 19, 8. https://doi.org/10.1186/s12933-019-0982-2 (2020).
doi: 10.1186/s12933-019-0982-2
pubmed: 31941513
pmcid: 6963998
Wang, R., Dai, L., Zhong, Y. & Xie, G. Usefulness of the triglyceride glucose-body mass index in evaluating nonalcoholic fatty liver disease: Insights from a general population. Lipids Health Dis. 20, 77. https://doi.org/10.1186/s12944-021-01506-9 (2021).
doi: 10.1186/s12944-021-01506-9
pubmed: 34321005
pmcid: 8317400
Li, N. et al. Value of the triglyceride glucose index combined with body mass index in identifying non-alcoholic fatty liver disease in patients with type 2 diabetes. BMC Endocr. Disord. 22, 101. https://doi.org/10.1186/s12902-022-00993-w (2022).
doi: 10.1186/s12902-022-00993-w
pubmed: 35428219
pmcid: 9011983