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Triglyceride-glucose index predicts future chronic kidney disease development in all populations, including normotensive and isolated diastolic hypertension

Hypertension Research volume 47, pages 149–156 (2024)Cite this article

A Comment to this article was published on 16 January 2024

Abstract

Hypertension and insulin resistance are established risk factors for chronic kidney disease. However, the association between chronic kidney disease and insulin resistance in detailed hypertension pattern groups such as isolated diastolic hypertension remains unclear. Triglyceride-glucose index has been noted as an indicator of insulin resistance. This study investigated the association between the triglyceride-glucose index and chronic kidney disease in four blood pressure groups: isolated diastolic hypertension, isolated systolic hypertension, systolic diastolic hypertension, and normotension. Using a database of 41,811 middle-aged men who had two or more annual health checkups from 2007 to 2019, those with chronic kidney disease at the first visit, antihypertensive/diabetes/dyslipidemia medication users, and incomplete data were excluded. Four groups were categorized using the 140/90 mmHg threshold. A COX proportional hazards model was used to assess the triglyceride-glucose index with incident chronic kidney disease. Participants were divided: isolated diastolic hypertension: 2207 (6.72%), isolated systolic hypertension: 2316 (7.06%), systolic-diastolic hypertension: 3299 (10.05%), normal: 24,996 (76.17%). The follow-up period was 6.78 years. Adjusted hazard ratios (HRs) and 95% CIs per unit increase in triglyceride-glucose index: isolated diastolic hypertension (HR = 1.31, 95% CI (1.06–1.62)), isolated systolic hypertension (HR = 1.36, 95% CI (1.12–1.64)), systolic-diastolic hypertension (HR = 1.40, 95% CI (1.19–1.64)), normal (HR = 1.18, 95% CI (1.09–1.28)). Triglyceride-glucose index is relevant for predicting chronic kidney disease development in all subtypes of hypertension. The results may lead to early prediction and prevention of the development of chronic kidney disease.

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Acknowledgements

We thank the medical staff at Kagoshima Kouseiren Medical Health Care Center for their support with data collection. We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

    Takashi Sakoda, Yuichi Akasaki, Yuichi Sasaki, Shin Kawasoe, Takuro Kubozono, Yoshiyuki Ikeda & Mitsuru Ohishi

  2. Kagoshima Kouseiren Hospital, Kagoshima, Japan

    Hironori Miyahara & Koichi Tokusige

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Sakoda, T., Akasaki, Y., Sasaki, Y. et al. Triglyceride-glucose index predicts future chronic kidney disease development in all populations, including normotensive and isolated diastolic hypertension. Hypertens Res 47, 149–156 (2024). https://doi.org/10.1038/s41440-023-01507-4

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