Article(id=1324077641388654992, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509218, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757606400000, receivedDateStr=2025-09-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614309879, onlineDateStr=2026-11-02, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614309879, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614309879, creator=13701087609, updateTime=1793614309879, updator=13701087609, issue=Issue{id=1324077560820282023, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='1774368000000', pubDateStr='2026-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614290671, creator='13701087609', updateTime=1793614391469, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077983656444429, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077983660638734, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077560820282023, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1042, endPage=1048, ext={EN=ArticleExt(id=1324077641665479057, articleId=1324077641388654992, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A cohort study on the relationship between weight status and related TyG indicators and elevated blood pressure in adolescents, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between body weight indicators and the TyG index (triglyceride-glucose index), as well as the combined indicators of these two factors, the triglyceride-glucose-weight index (TyG-BMI) and the triglyceride-glucose-waist circumference index (TyG-WC), and the risk of elevated blood pressure during follow-up among the adolescent population.

Methods

Using the convenient sampling method, students from the first, second and first-year senior grades of three schools in Sichuan Province were selected. A follow-up survey was conducted in March 2023, with an average follow-up period of 1.25 years and a dropout rate of 6.75%. The multivariate modified Poisson regression model was used to analyze the relationship between body mass index and TyG index, as well as the mixed indicators of the two (TyG-BMI and TyG-WC) and follow-up high blood pressure. The logistic regression model was used to explore the mediating effect of baseline TyG and follow-up TyG in the relationship between different body weight states and follow-up blood pressure levels.

Results

Among the 812 teenagers who did not have high blood pressure at the baseline, the average age was 14 years old, and 40.30% were male. During the follow-up period, a total of 156 teenagers developed high blood pressure, with an incidence rate of 19.21%. In the multivariate adjusted Poisson regression analysis, both TyG-BMI and TyG-WC showed a positive correlation with elevated blood pressure at the follow-up (TyG-BMI: RR=1.009, P<0.05; TyG-WC: RR=1.004, P<0.05). In the mediating effect model, no mediating effect of baseline and follow-up TyG in the relationship between different weight statuses and follow-up high blood pressure was found.

Conclusion

We found that TyG-BMI and TyG-WC were associated with high blood pressure, but weight status played a key role in it.

, authors=Ling-zhuang HU1, Tao GUAN2, Bao-feng CHEN3, Hui FAN4, authorsList=Ling-zhuang HU, Tao GUAN, Bao-feng CHEN, Hui FAN, authorCompany=null, correspAuthors=Bao-feng CHEN, Hui FAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077642487562644, articleId=1324077641388654992, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=青少年中体重状态及相关TyG指标与血压偏高关系的队列研究, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

基于本次队列研究探讨青少年人群中体重指标和TyG指数(三酰甘油-葡萄糖指数),以及二者的混合指标,三酰甘油-葡萄糖-体重指数(TyG-BMI)和三酰甘油-葡萄糖-腰围指数(TyG-WC)对随访血压偏高发病风险的关系。

方法

采用方便抽样法选取四川省3所学校初一、初二及高一年级的学生,于2023年3月开展随访,其平均随访时间为1.25年,失访率为6.75%。采用多因素修正泊松回归模型分析体重指标和TyG指数,以及二者的混合指标(TyG-BMI和TyG-WC)与随访血压偏高的关系,使用logistic回归模型探讨基线TyG和随访TyG在不同体重状态与随访血压水平关系中的中介效应。

结果

基线时未出现血压偏高的812名青少年,其平均年龄14岁,男性占40.30%,随访期间共有156名青少年出现血压偏高,血压偏高的发生率为19.21%。在多因素修正泊松回归分析中,TyG-BMI、TyG-WC与随访时血压偏高之间均显示呈正相关(TyG-BMI: RR=1.009, P<0.05;TyG-WC:RR=1.004, P<0.05)。在中介效应模型中,未发现基线和随访TyG在不同体重状态与随访血压偏高关系中的中介效应。

结论

我们发现TyG-BMI和TyG-WC与血压偏高存在关联,但在其中体重状态起到了关键作用。

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胡凌壮(2000—),男,硕士在读,研究方向:生命全程心血管流行病学

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陈保锋与范晖为共同通讯作者。
陈保锋,E-mail:
范晖,E-mail:
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注:*P<0.01。BMI:体质量指数;WC:腰围;中介效应分析中调整了基线变量(年龄、性别、民族、饮酒情况、吸烟情况、高血压家族史、“屏幕时间”活动和睡眠时间),随访时间。

, figureFileSmall=vkRjEoQMaxmPGE/9mio2tA==, figureFileBig=VrgUsn+3C1VW2y+NcrI7GA==, tableContent=null), ArticleFig(id=1324077648930013632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=EN, label=Table 1, caption=

The baseline characteristics of the subjects

, figureFileSmall=null, figureFileBig=null, tableContent=
变量全人群随访时的血压状态
血压偏高组血压正常组Z/t/χ2值P值
年龄/岁a14(13~16)14(13~16)14(13~15)-2.7760.006
男性b327(40.3)76(48.7)251(38.3)5.7280.017
民族b
汉族280(34.5)28(17.9)252(38.4)25.691<0.001
彝族513(63.2)126(80.8)387(58.9)
其他民族19(2.3)2(1.3)17(2.7)
学校b
学校A254(31.3)17(10.9)237(36.0)69.519<0.001
学校B233(28.7)32(20.5)201(31.0)
学校C325(40.0)107(68.6)218(33.0)
饮酒b139(17.1)20(12.8)119(18.1)2.5140.113
吸烟b43(5.3)10(6.4)33(5.0)0.4780.489
高血压家族史b59(7.3)13(8.3)46(7.0)0.3260.568
视屏时间(小时/天)a0.86(0.45~1.85)1.13(0.51~3.59)0.79(0.42~1.64)-3.1100.002
睡眠时间(小时/天)a8.37(7.86~8.85)8.33(7.93~8.85)8.38(7.86~8.85)-0.2080.835
WC(cm)a65.20(61.80~69.50)66.00(62.50~71.20)65.00(61.40~69.10)-3.2220.001
BMI(Kg/m2)a19.90(18.22~21.70)20.78(19.14~22.52)19.79(18.07~21.49)-4.657<0.001
SBP(mmHg)a105.00(98.42~111.33)111.00(104.00~114.67)104.00(97.67~110.00)-7.852<0.001
DBP(mmHg)a61.67(55.67~66.33)63.00(58.33~67.33)61.00(55.00~66.00)-3.468<0.001
FPG(mmol/L)4.69±0.434.83±0.414.65±0.42-4.804<0.001
TG(mmol/L)a0.86(0.67~1.12)0.83(0.65~1.12)0.86(0.67~1.11)-0.2160.829
TyGa8.09(7.82~8.34)8.08(7.87~8.36)8.08(7.80~8.33)-0.8210.412
TyG-BMIa160.07(145.65~177.24)169.42(153.17~182.57)158.45(144.74~175.92)-4.411<0.001
TyG-WCa525.81(492.45~564.76)534.73(502.27~582.47)523.82(488.77~560.17)-3.1320.002
), ArticleFig(id=1324077649018094017, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=CN, label=表1, caption=

受试者的基线特征

, figureFileSmall=null, figureFileBig=null, tableContent=
变量全人群随访时的血压状态
血压偏高组血压正常组Z/t/χ2值P值
年龄/岁a14(13~16)14(13~16)14(13~15)-2.7760.006
男性b327(40.3)76(48.7)251(38.3)5.7280.017
民族b
汉族280(34.5)28(17.9)252(38.4)25.691<0.001
彝族513(63.2)126(80.8)387(58.9)
其他民族19(2.3)2(1.3)17(2.7)
学校b
学校A254(31.3)17(10.9)237(36.0)69.519<0.001
学校B233(28.7)32(20.5)201(31.0)
学校C325(40.0)107(68.6)218(33.0)
饮酒b139(17.1)20(12.8)119(18.1)2.5140.113
吸烟b43(5.3)10(6.4)33(5.0)0.4780.489
高血压家族史b59(7.3)13(8.3)46(7.0)0.3260.568
视屏时间(小时/天)a0.86(0.45~1.85)1.13(0.51~3.59)0.79(0.42~1.64)-3.1100.002
睡眠时间(小时/天)a8.37(7.86~8.85)8.33(7.93~8.85)8.38(7.86~8.85)-0.2080.835
WC(cm)a65.20(61.80~69.50)66.00(62.50~71.20)65.00(61.40~69.10)-3.2220.001
BMI(Kg/m2)a19.90(18.22~21.70)20.78(19.14~22.52)19.79(18.07~21.49)-4.657<0.001
SBP(mmHg)a105.00(98.42~111.33)111.00(104.00~114.67)104.00(97.67~110.00)-7.852<0.001
DBP(mmHg)a61.67(55.67~66.33)63.00(58.33~67.33)61.00(55.00~66.00)-3.468<0.001
FPG(mmol/L)4.69±0.434.83±0.414.65±0.42-4.804<0.001
TG(mmol/L)a0.86(0.67~1.12)0.83(0.65~1.12)0.86(0.67~1.11)-0.2160.829
TyGa8.09(7.82~8.34)8.08(7.87~8.36)8.08(7.80~8.33)-0.8210.412
TyG-BMIa160.07(145.65~177.24)169.42(153.17~182.57)158.45(144.74~175.92)-4.411<0.001
TyG-WCa525.81(492.45~564.76)534.73(502.27~582.47)523.82(488.77~560.17)-3.1320.002
), ArticleFig(id=1324077649093591490, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=EN, label=Table 2, caption=

Multiple linear analysis of baseline TyG and its derived indices (TyG-BMI, TyG-WC) with blood pressure levels and blood pressure changes at follow-up

, figureFileSmall=null, figureFileBig=null, tableContent=
结局暴露模型1模型2
β(95%CI)Pβ(95%CI)P
随访SBPTyG-0.210(-2.070~1.650)0.8250.182(-1.564~1.927)0.838
TyG-BMI0.068(0.042~0.094)<0.0010.072(0.048~0.096)<0.001
TyG-WC0.034(0.023~0.045)<0.0010.032(0.023~0.042)<0.001
随访DBPTyG1.646(-0.334~3.626) 0.1030.577(-1.341~2.495) 0.555
TyG-BMI0.045(0.017~0.073) 0.0020.024(-0.003~0.050) 0.085
TyG-WC0.010(-0.001~0.022) 0.0850.012(0.001~0.023) 0.033
随访SBP与基线SBP差值TyG0.562(-1.349~2.472) 0.564-0.605(-2.414~1.204) 0.511
TyG-BMI0.025(-0.002~0.053) 0.0670.027(0.002~0.053) 0.035
TyG-WC0.007(-0.004~0.018) 0.2200.009(-0.001~0.019) 0.093
随访DBP与基线DBP差值TyG2.104(-0.047~4.255) 0.0550.600(-1.492~2.693) 0.573
TyG-BMI0.034(0.003~0.064) 0.0330.013(-0.016~0.043) 0.374
TyG-WC0.001(-0.012~0.013)0.9260.002(-0.010~0.014)0.729
), ArticleFig(id=1324077649173283267, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=CN, label=表2, caption=

基线的TyG及其衍生指数(TyG-BMI、TyG-WC)与随访时血压水平及血压变化的多重线性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
结局暴露模型1模型2
β(95%CI)Pβ(95%CI)P
随访SBPTyG-0.210(-2.070~1.650)0.8250.182(-1.564~1.927)0.838
TyG-BMI0.068(0.042~0.094)<0.0010.072(0.048~0.096)<0.001
TyG-WC0.034(0.023~0.045)<0.0010.032(0.023~0.042)<0.001
随访DBPTyG1.646(-0.334~3.626) 0.1030.577(-1.341~2.495) 0.555
TyG-BMI0.045(0.017~0.073) 0.0020.024(-0.003~0.050) 0.085
TyG-WC0.010(-0.001~0.022) 0.0850.012(0.001~0.023) 0.033
随访SBP与基线SBP差值TyG0.562(-1.349~2.472) 0.564-0.605(-2.414~1.204) 0.511
TyG-BMI0.025(-0.002~0.053) 0.0670.027(0.002~0.053) 0.035
TyG-WC0.007(-0.004~0.018) 0.2200.009(-0.001~0.019) 0.093
随访DBP与基线DBP差值TyG2.104(-0.047~4.255) 0.0550.600(-1.492~2.693) 0.573
TyG-BMI0.034(0.003~0.064) 0.0330.013(-0.016~0.043) 0.374
TyG-WC0.001(-0.012~0.013)0.9260.002(-0.010~0.014)0.729
), ArticleFig(id=1324077649286529476, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=EN, label=Table 3, caption=

The relationship between baseline weight status and TyG indicators and follow-up elevated blood pressure

, figureFileSmall=null, figureFileBig=null, tableContent=
基线变量血压偏高发病率(%)模型1模型2
RR(95%CI)PRR(95%CI)P
联合效应
TyG和BMI定义体重状态
低TyG和正常体重组(n=523)16.61.0001.000
高TyG和正常体重组(n=152)19.71.186(0.816~1.724)0.3691.194(0.851~1.676)0.306
低TyG和超重肥胖组(n=86)27.91.678(1.136~2.478)0.0091.889(1.313~2.718)<0.001
高TyG和超重肥胖组(n=51)29.41.768(1.108~2.819)0.0172.004(1.227~3.272)0.005
TyG和WC定义体重状态
低TyG和正常腰围组(n=505)17.81.0001.000
高TyG和正常腰围组(n=144)20.81.169(0.807~1.691)0.4071.148(0.821~1.605)0.421
低TyG和腹型肥胖组(n=104)20.21.133(0.740~1.733)0.5651.427(0.958~2.125)0.081
高TyG和腹型肥胖组(n=59)25.41.427(0.886~2.295)0.1431.832(1.127~2.978)0.015
交互效应
基线TyG和基线BMI交互作用
相乘交互
TyG1.186(0.816~1.724)0.3691.194(0.851~1.676)0.306
BMI1.678(1.136~2.478)0.0091.889(1.313~2.718)<0.001
基线TyG×基线BMI0.888(0.459~1.719)0.7250.889(0.465~1.699)0.721
相加交互指标
RERI-0.096(-1.202~1.009)-0.079(-1.237~1.079)
AP-0.054(-1.101~0.992)-0.039(-0.630~0.552)
SI0.888(0.249~3.179)0.927(0.125~3.683)
基线TyG和基线WC交互作用
相乘交互
TyG1.169(0.808~1.691)0.4071.148(0.821~1.605)0.421
WC1.133(0.740~1.733)0.5651.427(0.958~2.125)0.081
基线TyG×基线WC1.077(0.541~2.143)0.8331.119(0.578~2.166)0.738
相加交互指标
RERI0.125(-0.760~1.009)0.258(-0.766~1.283)
AP0.087(-0.705~0.879)0.141(-0.373~0.655)
SI 1.412(0.114~17.561)1.449(0.326~6.443)
混合指标效应
TyG-BMI1.008(1.005~1.011)<0.0011.009(1.005~1.013)<0.001
TyG-WC1.004(1.002~1.005)<0.0011.004(1.003~1.006)<0.001
), ArticleFig(id=1324077649370415557, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=CN, label=表3, caption=

基线体重状态和TyG指标与随访血压偏高的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
基线变量血压偏高发病率(%)模型1模型2
RR(95%CI)PRR(95%CI)P
联合效应
TyG和BMI定义体重状态
低TyG和正常体重组(n=523)16.61.0001.000
高TyG和正常体重组(n=152)19.71.186(0.816~1.724)0.3691.194(0.851~1.676)0.306
低TyG和超重肥胖组(n=86)27.91.678(1.136~2.478)0.0091.889(1.313~2.718)<0.001
高TyG和超重肥胖组(n=51)29.41.768(1.108~2.819)0.0172.004(1.227~3.272)0.005
TyG和WC定义体重状态
低TyG和正常腰围组(n=505)17.81.0001.000
高TyG和正常腰围组(n=144)20.81.169(0.807~1.691)0.4071.148(0.821~1.605)0.421
低TyG和腹型肥胖组(n=104)20.21.133(0.740~1.733)0.5651.427(0.958~2.125)0.081
高TyG和腹型肥胖组(n=59)25.41.427(0.886~2.295)0.1431.832(1.127~2.978)0.015
交互效应
基线TyG和基线BMI交互作用
相乘交互
TyG1.186(0.816~1.724)0.3691.194(0.851~1.676)0.306
BMI1.678(1.136~2.478)0.0091.889(1.313~2.718)<0.001
基线TyG×基线BMI0.888(0.459~1.719)0.7250.889(0.465~1.699)0.721
相加交互指标
RERI-0.096(-1.202~1.009)-0.079(-1.237~1.079)
AP-0.054(-1.101~0.992)-0.039(-0.630~0.552)
SI0.888(0.249~3.179)0.927(0.125~3.683)
基线TyG和基线WC交互作用
相乘交互
TyG1.169(0.808~1.691)0.4071.148(0.821~1.605)0.421
WC1.133(0.740~1.733)0.5651.427(0.958~2.125)0.081
基线TyG×基线WC1.077(0.541~2.143)0.8331.119(0.578~2.166)0.738
相加交互指标
RERI0.125(-0.760~1.009)0.258(-0.766~1.283)
AP0.087(-0.705~0.879)0.141(-0.373~0.655)
SI 1.412(0.114~17.561)1.449(0.326~6.443)
混合指标效应
TyG-BMI1.008(1.005~1.011)<0.0011.009(1.005~1.013)<0.001
TyG-WC1.004(1.002~1.005)<0.0011.004(1.003~1.006)<0.001
), ArticleFig(id=1324077649454301638, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=EN, label=Table 4, caption=

The relationship between the changes of TyG, TyG-BMI and TyG-WC at baseline and follow-up and the high blood pressure at follow-up

, figureFileSmall=null, figureFileBig=null, tableContent=
基线变量血压偏高发病率(%)模型1模型2
RR(95%CI)PRR(95%CI)P
TyG分组
TyG持续正常组(n=469)16.21.0001.000
TyG由高转正常组(n=140)24.31.496(1.045~2.140)0.0281.414(1.005~1.991)0.047
TyG由正常转高组(n=141)24.81.529(1.073~2.178)0.0181.427(0.999~2.039)0.051
TyG持续升高组(n=62)17.71.093(0.614~1.943)0.7631.316(0.752~2.304)0.336
TyG-BMI分组
TyG-BMI持续正常组(n=541)15.91.0001.000
TyG-BMI由高转正常组(n=69)28.91.823 (1.200~2.770)0.0051.624 (1.069~2.467)0.023
TyG-BMI由正常转高组(n=68)251.573 (0.997~2.482)0.0521.556 (1.017~2.381)0.042
TyG-BMI持续升高组(n=134)24.61.549 (1.086~2.209)0.0161.846 (1.289~2.645)<0.001
TyG-WC分组
TyG-WC持续正常组(n=532)15.91.0001.000
TyG-WC由高转正常组(n=77)14.30.894 (0.499~1.601)0.7060.880 (0.501~1.546)0.658
TyG-WC由正常转高组(n=77)28.61.788 (1.194~2.679)0.0051.544 (1.034~2.306)0.033
TyG-WC持续升高组(n=126)30.21.888 (1.357~2.626)<0.0011.939 (1.415~2.659)<0.001
), ArticleFig(id=1324077649533993415, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077641388654992, language=CN, label=表4, caption=

基线和随访时TyG、TyG-BMI、TyG-WC的变化情况与随访时血压偏高的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
基线变量血压偏高发病率(%)模型1模型2
RR(95%CI)PRR(95%CI)P
TyG分组
TyG持续正常组(n=469)16.21.0001.000
TyG由高转正常组(n=140)24.31.496(1.045~2.140)0.0281.414(1.005~1.991)0.047
TyG由正常转高组(n=141)24.81.529(1.073~2.178)0.0181.427(0.999~2.039)0.051
TyG持续升高组(n=62)17.71.093(0.614~1.943)0.7631.316(0.752~2.304)0.336
TyG-BMI分组
TyG-BMI持续正常组(n=541)15.91.0001.000
TyG-BMI由高转正常组(n=69)28.91.823 (1.200~2.770)0.0051.624 (1.069~2.467)0.023
TyG-BMI由正常转高组(n=68)251.573 (0.997~2.482)0.0521.556 (1.017~2.381)0.042
TyG-BMI持续升高组(n=134)24.61.549 (1.086~2.209)0.0161.846 (1.289~2.645)<0.001
TyG-WC分组
TyG-WC持续正常组(n=532)15.91.0001.000
TyG-WC由高转正常组(n=77)14.30.894 (0.499~1.601)0.7060.880 (0.501~1.546)0.658
TyG-WC由正常转高组(n=77)28.61.788 (1.194~2.679)0.0051.544 (1.034~2.306)0.033
TyG-WC持续升高组(n=126)30.21.888 (1.357~2.626)<0.0011.939 (1.415~2.659)<0.001
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青少年中体重状态及相关TyG指标与血压偏高关系的队列研究
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胡凌壮 1 , 关陶 2 , 陈保锋 3 , 范晖 4
现代预防医学 | 儿少卫生与妇幼保健 2026,53(6): 1042-1048
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (6) : 1042 -1048
青少年中体重状态及相关TyG指标与血压偏高关系的队列研究
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胡凌壮1, 关陶2, 陈保锋3 , 范晖4
作者信息
  • 1.川北医学院公共卫生学院,四川 南充 637000
  • 2.凉山彝族自治州疾病预防控制中心公共卫生检测所
  • 3.川北医学院基础医学与法医学院
  • 4.川北医学院公共卫生学院流行病与卫生统计学教研室
通讯作者:
陈保锋与范晖为共同通讯作者。
陈保锋,E-mail:
范晖,E-mail:
作者简介:

胡凌壮(2000—),男,硕士在读,研究方向:生命全程心血管流行病学

A cohort study on the relationship between weight status and related TyG indicators and elevated blood pressure in adolescents
Ling-zhuang HU1, Tao GUAN2, Bao-feng CHEN3 , Hui FAN4
Affiliations
  • School of Public Health, North Sichuan Medical College, Nanchong, Sichuan 637000, China
出版时间: 2026-03-25 doi: 10.20043/j.cnki.MPM.202509218
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目的

基于本次队列研究探讨青少年人群中体重指标和TyG指数(三酰甘油-葡萄糖指数),以及二者的混合指标,三酰甘油-葡萄糖-体重指数(TyG-BMI)和三酰甘油-葡萄糖-腰围指数(TyG-WC)对随访血压偏高发病风险的关系。

方法

采用方便抽样法选取四川省3所学校初一、初二及高一年级的学生,于2023年3月开展随访,其平均随访时间为1.25年,失访率为6.75%。采用多因素修正泊松回归模型分析体重指标和TyG指数,以及二者的混合指标(TyG-BMI和TyG-WC)与随访血压偏高的关系,使用logistic回归模型探讨基线TyG和随访TyG在不同体重状态与随访血压水平关系中的中介效应。

结果

基线时未出现血压偏高的812名青少年,其平均年龄14岁,男性占40.30%,随访期间共有156名青少年出现血压偏高,血压偏高的发生率为19.21%。在多因素修正泊松回归分析中,TyG-BMI、TyG-WC与随访时血压偏高之间均显示呈正相关(TyG-BMI: RR=1.009, P<0.05;TyG-WC:RR=1.004, P<0.05)。在中介效应模型中,未发现基线和随访TyG在不同体重状态与随访血压偏高关系中的中介效应。

结论

我们发现TyG-BMI和TyG-WC与血压偏高存在关联,但在其中体重状态起到了关键作用。

青少年  /  血压偏高  /  三酰甘油-葡萄糖指数  /  三酰甘油-葡萄糖-体重指数  /  三酰甘油-葡萄糖-腰围指数  /  体重状态
Objective

To explore the relationship between body weight indicators and the TyG index (triglyceride-glucose index), as well as the combined indicators of these two factors, the triglyceride-glucose-weight index (TyG-BMI) and the triglyceride-glucose-waist circumference index (TyG-WC), and the risk of elevated blood pressure during follow-up among the adolescent population.

Methods

Using the convenient sampling method, students from the first, second and first-year senior grades of three schools in Sichuan Province were selected. A follow-up survey was conducted in March 2023, with an average follow-up period of 1.25 years and a dropout rate of 6.75%. The multivariate modified Poisson regression model was used to analyze the relationship between body mass index and TyG index, as well as the mixed indicators of the two (TyG-BMI and TyG-WC) and follow-up high blood pressure. The logistic regression model was used to explore the mediating effect of baseline TyG and follow-up TyG in the relationship between different body weight states and follow-up blood pressure levels.

Results

Among the 812 teenagers who did not have high blood pressure at the baseline, the average age was 14 years old, and 40.30% were male. During the follow-up period, a total of 156 teenagers developed high blood pressure, with an incidence rate of 19.21%. In the multivariate adjusted Poisson regression analysis, both TyG-BMI and TyG-WC showed a positive correlation with elevated blood pressure at the follow-up (TyG-BMI: RR=1.009, P<0.05; TyG-WC: RR=1.004, P<0.05). In the mediating effect model, no mediating effect of baseline and follow-up TyG in the relationship between different weight statuses and follow-up high blood pressure was found.

Conclusion

We found that TyG-BMI and TyG-WC were associated with high blood pressure, but weight status played a key role in it.

Adolescents  /  Elevated blood pressure  /  Triglyceride-glucose index  /  Triglyceride-glucose-body mass index  /  Triglyceride-glucose-waist circumference index  /  Weight status
胡凌壮, 关陶, 陈保锋, 范晖. 青少年中体重状态及相关TyG指标与血压偏高关系的队列研究. 现代预防医学, 2026 , 53 (6) : 1042 -1048 . DOI: 10.20043/j.cnki.MPM.202509218
Ling-zhuang HU, Tao GUAN, Bao-feng CHEN, Hui FAN. A cohort study on the relationship between weight status and related TyG indicators and elevated blood pressure in adolescents[J]. Modern Preventive Medicine, 2026 , 53 (6) : 1042 -1048 . DOI: 10.20043/j.cnki.MPM.202509218
在1990年至2019年期间全球心血管病患病人数从2.7亿人增加至5.23亿人[1]。高血压疾病是导致人类心血管疾病的主要原因之一。近年来随着经济快速地发展和生活方式的改变,高血压的发病逐渐年轻化[2],在年轻人中由高血压导致的心血管疾病负担也越来越沉重[3]。2020年,我国儿童高血压总患病率为3.11%,影响约680万6-18岁儿童[4]。因此,预防儿童青少年高血压具有重要意义。
先前研究发现胰岛素抵抗(IR)是高血压的危险因素之一[5-6]。评估IR水平传统的方式是用稳态模型胰岛素抵抗指数(HOMA-IR),但HOMA-IR存在测量复杂,重复性差,不易获得等问题[7]。TyG及其衍生指数(TyG-BMI和TyG-WC)是近几年提出的相关指标,这些指数具有简便、快捷的优点,并且研究发现TyG-BMI、TyG-WC与单独的TyG指数相比可以更好地反映胰岛素抵抗[8-9],从而代替传统检测方法。有相关的研究证明TyG及其衍生指数(TyG-BMI和TyG-WC)与血压存在关联[9]。但是,现有的大多是横断面研究并且主要关注中老年人群,在青少年人群中是否存在关联尚不清楚。因此,基于四川省青少年人群,我们设计了本次队列研究,以探讨四川省青少年人群中体重指标和TyG指数,以及二者的混合指标(TyG-BMI和TyG-WC)与随访血压偏高的关系,为防控青少年血压偏高提供科学依据。
本项队列研究于2021年10月在四川省开展。研究首先通过方便抽样选取了3所学校(分别标记为A、B、C),这3所学校均涵盖初中和高中阶段。随后,在每所学校中针对初一、初二及高一年级,随机抽取3个班级,每所学校共计抽取9个班级,且将所选班级的全体青少年纳入研究范围,共1 097人。2023年3月开展随访,我们去除因转学等原因失访人群后纳入了1 023名青少年的信息,将基线时已出现血压偏高,共211名青少年排除,剩余812名青少年纳入本次研究,此研究的随访平均时间为1.25年,失访率为6.75%。
本研究获得了川北医学院伦理审查委员会的批准(批准号:202150),所有参与者以及其监护人均签署知情同意书。
我们通过调查问卷收集了研究对象的一般人口学信息。具体来说,收集了社会经济特征,包括性别、年龄、民族(汉族、彝族、其他民族)、学校(A、B、C)。进一步收集生活习惯,包括饮酒(近一个月是否饮酒)、吸烟(近一个月是否吸烟)、睡眠时间(最近一个月睡眠时间,小时/天)、视屏时间(最近一个月观看电视和使用电脑/笔记本/手机时间,小时/天)。
由受过培训的专业人员使用经过校准的仪器测量儿童的身高、体重和血压。在对研究对象进行身高和体重测量时,研究对象需要脱去鞋子和身着轻便的衣物,垂直站立,以获取精确的结果。并计算体重指数(body mass index, BMI)=体重(kg)/[身高(m)]2。腰围(WC)的测量则借助尼龙带尺完成。被测者需保持站立姿势,双脚间距大约1 cm,利用软尺沿着肚脐水平环绕腹部一周来确定腰围尺寸,结果以cm表示。在安静环境中,研究对象休息10分钟后,使用校正过的欧姆龙HBP-1320电子血压计测量右臂血压mmHg,共测三次,取平均值用于分析。
收集研究对象的生化指标时要求研究对象空腹12 h。收集的生化指标包括空腹血糖(FPG)、甘油三酯(TG),并使用全自动生化分析仪对其进行检测。
TyG=Ln[TG(mg/dL)×FPG(mg/dL)/2][10];TyG-BMI=TyG×BMI(kg/m2)[11];TyG-WC=TyG×WC(cm)[11]。
血压标准:采用中国儿童青少年血压参照标准,即收缩压(SBP)或舒张压(DBP)≥同年龄、同性别、同身高的第90百分位值即为血压偏高[12]。腰围标准:根据中国儿童和青少年腰围参考标准,腰围增加指腰围≥年龄别和性别的第75百分位值[13]。超重肥胖标准:BMI≥中国儿童超重肥胖行业标准中性别、年龄别的相应超重切点,则儿童属于超重肥胖儿童[14]。
目前TyG、TyG-BMI、TyG-WC指数的正常值暂无国际统一标准[15],按照以往的参考文献[16],使用四分位数法来评估青少年TyG、TyG-BMI、TyG-WC状态,分别将青少年基线时的TyG、TyG-BMI、TyG-WC指数≥相应第75百分位值(P75)定义为高值组,<P75定义为正常(低值)组。类似的,我们将随访时的TyG、TyG-BMI、TyG-WC指数按照上述方法进行分组。
根据基线时的TyG分组标准和超重肥胖(腰围)标准分别组合为四组:低/高TyG×正常体重/超重肥胖,以及低/高TyG×正常腰围/腹型肥胖。
根据研究对象在基线和随访时的TyG、TyG-BMI及TyG-WC分组标准,分别将其分为四组:持续正常组:基线与随访时指标均正常组;由高转正常组:基线时指标升高,随访时恢复正常;由正常转高组:基线时指标正常,随访时升高;持续升高组:基线与随访时指标均高。该分组方式分别应用于TyG-BMI、TyG和TyG-WC三项指标。
采用R 4.5.2软件进行数据分析。采用Kolmogorov-Smirnov检验数据的正态分布。符合正态分布的计量资料采用均数±标准差表示,非正态分布的计量资料用中位数(四分位数间距)[M(P25,P75)]表示。两组间的差异性比较采用成组t检验或Wilcoxon秩和检验。计数资料用人数和百分比(%)表示,采用χ2检验进行组间比较。
调整协变量(年龄、性别、民族、饮酒情况、吸烟情况、高血压家族史、“屏幕时间”活动、睡眠时间以及随访时间因素)后,分别使用12个独立的多重线性回归模型分析三种暴露(基线TyG、TyG-BMI、TyG-WC)与四种结局(随访时SBP、DBP、DBP变化值、SBP变化值)的关系。调整了上述协变量后使用修正泊松回归模型[17],分别分析基线体重状态和TyG指标的联合效应、交互效应、混合指标效应与随访时血压偏高的关系。通过构建暴露类别的哑变量(以基线低TyG和正常体重状态为参照)计算相对超额风险比(RERI)、归因比例(AP)、协同指数(SI)来评估相加交互作用,若存在相加交互作用RERI、AP的95% CI不包括0,SI95% CI不包括1[18],其95% CI通过Delta方法获得[19]。
进一步采用修正泊松回归模型分析基线和随访TyG变化、基线和随访TyG-BMI变化、基线和随访TyG-WC变化与随访时血压偏高的关系。
基于四个logistic回归模型,分别以基线和随访高TyG(二分类)为中介变量,探讨其在不同体重状态(二分类)与随访血压偏高(二分类)关系中的中介效应。
所有模型中的自变量(年龄、性别、民族、饮酒情况、吸烟情况、高血压家族史、“屏幕时间”活动、睡眠时间和随访时间)膨胀因子(VIF)均<5,不存在共线性问题。检验水准α=0.05。
本研究共纳入812例研究对象,其中男性327例,女性485例,年龄14(13~16)岁。血压偏高组与血压正常组在年龄、民族、学校、视屏时间、腰围、BMI、SBP、DBP、FPG、TyG-BMI及TyG-WC比较的差异均有统计学意义(P<0.01)。见表1。
调整混杂因素后,多重线性回归结果显示:TyG-BMI(β=0.072,95% CI:0.048~0.096,P<0.001)、TyG-WC(β=0.032,95% CI:0.023~0.042;P<0.001)分别与随访时SBP存在正相关关系;TyG-BMI与随访SBP与基线SBP差值也呈现正相关关系(β=0.027,95% CI:0.002~0.053,P=0.035)。见表2。
多因素修正泊松回归分析发现,在联合效应中将基线TyG与BMI定义体重状态分组后,结果显示高TyG和超重肥胖组发生血压偏高风险是低TyG和正常体重组的2.004倍(95% CI:1.227~3.272);将基线TyG与WC定义体重状态联合分组后,我们观察到类似的结局。交互作用分析发现:在相乘交互尺度、相加交互尺度上均未发现基线TyG指数与BMI或腰围在随访血压偏高中存在显著的交互作用。混合指标效应分析发现:基线TyG-WC和TyG-BMI均与随访血压偏高呈现正相关(P<0.001)。见表3。
调整了年龄、性别、民族、饮酒情况、吸烟情况、高血压家族史、“屏幕时间”活动、睡眠时间和随访时间后,结果显示:基线和随访TyG-BMI均高组发生血压偏高风险是基线和随访TyG-BMI均正常组的1.846倍(95% CI: 1.289~2.645);基线和随访TyG-WC均高组发生血压偏高风险是基线和随访TyG-WC均正常组的1.939倍(95% CI:1.415~2.659)。见表4。
研究显示:无论基线BMI定义的体重状态还是基线WC定义的体重状态对随访时血压偏高均具有显著的直接效应,但基线TyG和随访TyG在这一因果路径中均未发现中介作用。
通过这项基于青少年人群的队列研究,我们发现:基线TyG-BMI、基线TyG-WC与随访期血压偏高有关;基线和随访持续性的高TyG-BMI、高TyG-WC增加血压偏高的风险;无论是基线TyG还是随访TyG,我们未发现其在不同体重状态与随访血压偏高关系中的中介效应。
既往有大量成年人群横断面研究和队列研究发现TyG-BMI和TyG-WC与高血压密切相关[20-21]。例如:在我国开展的一项横断面研究显示TyG-BMI与血压之间存在相关性,并且这种相关性在年轻和中年人群中更为明显[22]。此外,纵向研究表明TyG-BMI和TyG-WC的升高增加高血压的风险[23]。但相关研究在青少年中较少。以往横断面研究发现:在青少年中,当TyG-BMI和TyG-WC处于高值时,血压异常的风险会升高[24]。本队列研究进一步证实:青少年中,基线TyG-BMI、基线TyG-WC与随访时的SBP、随访时血压偏高有关。我们的研究还发现基线到随访持续的高TyG-BMI、TyG-WC均会增加血压偏高的风险。
此外,我们的研究提供了新的信息:无论基线TyG处于何种水平,基线高BMI均会增加随访时血压偏高的风险(见表3);无论是基线TyG还是随访TyG,我们未发现其在基线超重肥胖与随访血压偏高关系中的中介效应。以上结果说明在短期随访过程中BMI可能还没有通过胰岛素抵抗来导致血压偏高。虽然有相关的研究显示超重肥胖可以通过引起胰岛素抵抗的发生从而导致血压偏高[25-26],但这一变化过程可能需要一定的时间,而本次队列研究随访时间较短并未发现TyG直接导致血压偏高,在短期的随访中较高水平的TyG-BMI、TyG-WC可能主要还是由高BMI或高WC来引起的血压偏高。在短期的随访时间高BMI、高WC导致的血压偏高的机制可能如下:(1)肥胖与交感神经活动增加和副交感神经活动减少有关,在这些因素的作用下导致外周血管收缩、外周血管阻力增加,进而导致血压上升。(2)当脂肪增多时,脂肪细胞可通过局部产生血管紧张素II和醛固酮,以旁分泌方式作用于周围血管、神经和脂肪组织本身,协同促进血管收缩、钠潴留和炎症,最终导致血压升高[27]。
本研究的优势在于此次开展的是一项队列研究,因果论证强度高。本研究还存在一定的局限性:首先,此次研究的样本量较少,并且本研究是基于四川省青少年人群开展的,所得结论外推受限,以及研究随访时间较短,可能影响研究结果;其次,我们的随访TyG与血压升高是同时随访测量的,在进行肥胖测量-TyG随访水平-血压升高这组的中介分析时时间前后顺序的设计上并不太理想;最后,在设计和实施的过程中还可能有混杂因素并未识别,从而影响到结果。
综上所述,基于青少年人群的短期队列研究,我们发现TyG-BMI和TyG-WC与血压偏高存在关联,但在其中体重状态起到了关键作用。未来还需要在大样本、长时间随访基础上进一步分析TyG-BMI和TyG-WC与血压偏高的关系。
  • 川北医学院博士科研启动基金项目和重点培育项目(CBY18-QD02; CBY22-ZDB02)
  • 凉山州科技计划重点研发项目(21ZDYF0123)
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2026年第53卷第6期
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doi: 10.20043/j.cnki.MPM.202509218
  • 接收时间:2025-09-12
  • 首发时间:2026-11-02
  • 出版时间:2026-03-25
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  • 收稿日期:2025-09-12
基金
川北医学院博士科研启动基金项目和重点培育项目(CBY18-QD02; CBY22-ZDB02)
凉山州科技计划重点研发项目(21ZDYF0123)
作者信息
    1.川北医学院公共卫生学院,四川 南充 637000
    2.凉山彝族自治州疾病预防控制中心公共卫生检测所
    3.川北医学院基础医学与法医学院
    4.川北医学院公共卫生学院流行病与卫生统计学教研室

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陈保锋与范晖为共同通讯作者。
陈保锋,E-mail:
范晖,E-mail:
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202509218
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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