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Article(id=1321169942775451997, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169924697993338, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146116, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1728489600000, receivedDateStr=2024-10-10, revisedDate=1734105600000, revisedDateStr=2024-12-14, acceptedDate=1743523200000, acceptedDateStr=2025-04-02, onlineDate=1792921060508, onlineDateStr=2026-10-25, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921060508, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921060508, creator=13701087609, updateTime=1792921060508, updator=13701087609, issue=Issue{id=1321169924697993338, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='5', pageStart='513', pageEnd='640', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921056198, creator='13701087609', updateTime=1792921056198, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=539, endPage=545, ext={EN=ArticleExt(id=1321169943119384927, articleId=1321169942775451997, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Effect of TyG combined with obesity indicators on prevalence of hypertension and hyperuricemia comorbidity among residents aged 35 years and older in Hebei province: a surveillance data analysis, columnId=1321169943039693150, journalTitle=Chinese Journal of Public Health, columnName=Special Report–Healthy Living for Chronic Disease Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effect of the triglyceride-glucose index (TyG) combined with various obesity indicators on the prevalence of comorbid hypertension and hyperuricemia among residents aged 35 years and older in Hebei province, and to provide a reference for the prevention and treatment of this comorbidity in the population.

Methods

Data from 7 859 permanent residents aged 35 years and older were collected as part of the Cardiovascular Disease and Risk Factor Surveillance Project, conducted in 10 districts/counties/cities of Hebei province between April and December 2020. A multivariable logistic regression model was used to analyze the relationship between the TyG, overweight/obesity, central obesity, and waist-to-height ratio (WHtR) with the prevalence of comorbid hypertension and hyperuricemia. The additive interaction between TyG and different obesity indicators on the prevalence of comorbid hypertension and hyperuricemia was assessed using relative excess risk due to interaction (‌RERI). The predictive value of TyG and different obesity indicators for comorbid hypertension and hyperuricemia was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results

Among 7 859 surveyed residents, 30.73% (2 415) were non-overweight/obese, while 69.27% (5 444) were overweight/obese; 43.80% (3 442) were non-centrally obese, and 56.20% (4 417) were centrally obese; 30.70% (2 413) had a normal WHtR, and 69.30% (5 446) had a high WHtR; 44.22% (3 475) had a low TyG (≤ 8.42), and 55.78% (4 384) had a high TyG (≥ 8.43). Additionally, 11.95% (939) had comorbid hypertension and hyperuricemia. After adjusting for sex, age, education, residence, physical activity, current smoking, alcohol consumption, and diabetes, multivariable logistic regression analysis revealed a significantly increased risk of comorbid hypertension and hyperuricemia among residents with central obesity (odds ratio [OR] = 1.676, 95% confidence interval [95%CI]: 1.346 - 2.087), overweight or obesity (OR = 1.440, 95%CI: 1.148 - 1.807), high WHtR (OR = 1.297, 95%CI: 1.001 - 1.679), and high TyG (OR = 2.335, 95%CI: 1.974 - 2.763), compared to residents who were not centrally obese, not overweight or obese, had normal WHtR, and had low TyG. The multivariable logistic regression results also showed significantly higher risks of comorbid hypertension and hyperuricemia among residents with both high TyG and high obesity indicators, including overweight or obesity (OR = 5.159, 95%CI: 3.916 - 6.796), central obesity (OR = 5.587, 95%CI: 4.357 - 7.164), and high WHtR (OR = 5.326, 95%CI: 4.038 - 7.026), compared to residents with low TyG and no overweight or obesity, no central obesity, and low WHtR, indicating an additive interaction between TyG and obesity indicators in comorbid hypertension and hyperuricemia. ROC analysis demonstrated that TyG combined with waist circumference (WC) had a higher predictive power for comorbid hypertension and hyperuricemia (AUC = 0.725, 95%CI: 0.715 - 0.735), indicating better diagnostic accuracy compared to TyG combined with body mass index (BMI), TyG combined with WHtR, or TyG alone.

Conclusions

High TyG, overweight/obesity, central obesity, and high WHtR are all associated with an increased risk of hypertension combined with hyperuricemia in residents aged 35 years and older in Hebei province. An additive interaction exists between TyG and different obesity indicators. TyG combined with WC could serve as an effective predictor for hypertension combined with hyperuricemia.

, authors=Lijuan TANG, Yajing CAO, Jinchai GAO, Fujuan YUE, Yifu GAO, Fan ZHANG, Weiwei SHI, Dongsheng JIANG, authorsList=Lijuan TANG, Yajing CAO, Jinchai GAO, Fujuan YUE, Yifu GAO, Fan ZHANG, Weiwei SHI, Dongsheng JIANG, authorCompany=null, correspAuthors=Dongsheng JIANG, authorNote=null, correspAuthorsNote=
JIANG Dongsheng, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., 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=1321169943832416609, articleId=1321169942775451997, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系, columnId=1321169943232631136, journalTitle=中国公共卫生, columnName=专题报道——健康生活方式，预防慢性病, runingTitle=null, highlight=null, articleAbstract=
目的

了解河北省≥35岁居民三酰甘油–葡萄糖乘积指数（TyG）和不同肥胖指标与高血压合并高尿酸血症患病的关系，为该地区居民高血压合并高尿酸血症的防治提供参考依据。

方法

收集2020年4—12月河北省心血管病及其危险因素监测项目10个监测点调查中7 859名≥35岁常住居民的相关数据，应用多因素非条件logistic回归模型分析TyG和超重/肥胖、中心型肥胖、腰高比（WHtR）等不同肥胖指标与高血压合并高尿酸血症患病的关系，计算TyG与不同肥胖指标对高血压合并高尿酸血症患病的相加交互作用，并采用受试者工作特征（ROC）曲线下面积（AUC）评估TyG和不同肥胖指标对高血压合并高尿酸血症患病的预测价值。

结果

河北省纳入分析的7 859名≥35岁居民中，非超重/肥胖者2 415人（30.73%），超重/肥胖者5 444人（69.27%）；非中心型肥胖者3 442人（43.80%），中心型肥胖者4 417人（56.20%）；非高WHtR者2 413人（30.70%），高WHtR者5 446人（69.30%）；低TyG（≤8.42）者3 475人（44.22%），高TyG（≥8.43）者4 384人（55.78%）；患高血压合并高尿酸血症者939例，高血压合并高尿酸血症患病率为11.95%。在调整了性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况和是否糖尿病等混杂因素后，多因素非条件logistic回归分析结果显示，河北省≥35岁中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁非中心型肥胖居民的1.676倍（OR=1.676，95%CI=1.346～2.087），≥35岁超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁非超重/肥胖居民的1.440倍（OR=1.440，95%CI=1.148～1.807），≥35岁高WHtR居民高血压合并高尿酸血症患病风险为≥35岁非高WHtR居民的1.297倍（OR=1.297，95%CI=1.001～1.679），≥35岁高TyG居民高血压合并高尿酸血症患病风险为≥35岁低TyG居民的2.335倍（OR=2.335，95%CI=1.974～2.763）；TyG与不同肥胖指标对高血压合并高尿酸血症患病均存在相加交互作用，≥35岁高TyG且超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非超重/肥胖居民的5.159倍（OR=5.159，95%CI=3.916～6.796），≥35岁高TyG且中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非中心型肥胖居民的5.587倍（OR=5.587，95%CI=4.357～7.164），≥35岁高TyG且高WHtR居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非WHtR居民的5.326倍（OR=5.326，95%CI=4.038～7.026）；ROC分析结果显示，TyG+腰围（WC）对高血压合并高尿酸血症的预测效力优于TyG+体质指数（BMI）、TyG+WHtR和单一TyG指标，AUC为0.725（95%CI=0.715～0.735）。

结论

高TyG、超重/肥胖、中心型肥胖和高WHtR均可增加河北省≥35岁居民高血压合并高尿酸血症的患病风险，且TyG与不同肥胖指标间存在相加交互作用，可将TyG+WC作为预测高血压合并高尿酸血症患病的有效指标。

, authors=唐丽娟, 曹亚景, 高金钗, 岳福娟, 高屹福, 张帆, 史卫卫, 蒋东升*, *, authorsList=唐丽娟, 曹亚景, 高金钗, 岳福娟, 高屹福, 张帆, 史卫卫, 蒋东升, authorCompany=null, correspAuthors=蒋东升, authorNote=

唐丽娟（1982—），副主任技师，博士，研究方向：慢性病预防与控制

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蒋东升，E-mail：
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唐丽娟（1982—），副主任技师，博士，研究方向：慢性病预防与控制

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Number of participants and prevalence of hypertension and hyperuricemia comorbidity among 7 859 residents aged 35 years and above surveyed in Hebei province (2020), stratified by demographics, lifestyle factors, diabetes, overweight/obesity, central obesity, waist-to-height ratio, and triglyceride-glucose index

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特征分类调查人数高血压合并高尿酸血症患病例数高血压合并高尿酸血症患病率/%χ2值P值
性别男性3 78157415.1872.398<0.001
女性4 0783658.95
年龄/岁35～442 37124810.4629.814<0.001
45～542 00320810.38
55～641 44918112.49
65～741 06514413.52
≥7597115816.27
文化程度初中及以下6 02867111.1317.737<0.001
高中1 26017714.05
大专及以上5719115.94
居住地城市3 21342013.076.5250.011
农村4 64651911.17
身体活动不充足2 17727812.771.9330.164
充足5 68266111.63
现在吸烟否5 97065711.0120.641<0.001
是1 87928014.90
饮酒过去和现在均不饮酒5 2055129.8473.311<0.001
过去饮酒但现在不饮酒6398212.83
过去和现在均饮酒2 00534317.11
糖尿病否6 81773210.7471.579<0.001
是1 04220719.87
超重/肥胖否2 4151445.96118.716<0.001
是5 44479514.60
中心型肥胖否3 4422146.22191.179<0.001
是4 41772516.41
高WHtR否2 4131506.22108.739<0.001
是5 44678914.49
TyG低3 4752136.13200.47<0.001
高4 38472616.56
), ArticleFig(id=1321169951126311327, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169942775451997, language=CN, label=表1, caption=

河北省不同特征≥35岁居民高血压合并高尿酸血症患病情况比较

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特征分类调查人数高血压合并高尿酸血症患病例数高血压合并高尿酸血症患病率/%χ2值P值
性别男性3 78157415.1872.398<0.001
女性4 0783658.95
年龄/岁35～442 37124810.4629.814<0.001
45～542 00320810.38
55～641 44918112.49
65～741 06514413.52
≥7597115816.27
文化程度初中及以下6 02867111.1317.737<0.001
高中1 26017714.05
大专及以上5719115.94
居住地城市3 21342013.076.5250.011
农村4 64651911.17
身体活动不充足2 17727812.771.9330.164
充足5 68266111.63
现在吸烟否5 97065711.0120.641<0.001
是1 87928014.90
饮酒过去和现在均不饮酒5 2055129.8473.311<0.001
过去饮酒但现在不饮酒6398212.83
过去和现在均饮酒2 00534317.11
糖尿病否6 81773210.7471.579<0.001
是1 04220719.87
超重/肥胖否2 4151445.96118.716<0.001
是5 44479514.60
中心型肥胖否3 4422146.22191.179<0.001
是4 41772516.41
高WHtR否2 4131506.22108.739<0.001
是5 44678914.49
TyG低3 4752136.13200.47<0.001
高4 38472616.56
), ArticleFig(id=1321169951210197408, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169942775451997, language=EN, label=Tab.2, caption=

Prevalence and odds ratios (from univariate and multivariate analyses) of hypertension and hyperuricemia comorbidity associated with low/high triglyceride-glucose index among Hebei provincial residents (≥ 35 years old) with or without overweight/obesity, central obesity, and high waist-to-height ratio

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项目高血压合并高尿酸血症患病数高血压合并高尿酸血症患病率/%单因素分析多因素分析
OR值95%CIOR值95%CI
低TyG且非超重/肥胖604.031.0001.000
高TyG且非超重/肥胖849.072.3761.688～3.3452.2771.613～3.214
低TyG且超重/肥胖153 7.701.9881.463～2.7012.0121.477～2.739
高TyG且超重/肥胖642 18.575.4304.136～7.1285.1593.916～6.796
低TyG且非中心型肥胖773.871.0001.000
高TyG且非中心型肥胖137 9.452.5951.946～3.4612.4861.860～3.323
低TyG且中心型肥胖136 9.172.5111.883～3.3492.3291.742～3.114
高TyG且中心型肥胖589 20.076.2474.889～7.9815.5874.357～7.164
低TyG且非高WHtR604.071.0001.000
高TyG且非高WHtR909.612.5081.789～3.5152.2211.579～3.125
低TyG且高WHtR153 7.651.9561.440～2.6572.0821.526～2.840
高TyG且高WHtR636 18.45 5.3404.067～7.0115.3264.038～7.026
), ArticleFig(id=1321169951403135393, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169942775451997, language=CN, label=表2, caption=

TyG与不同肥胖指标对高血压合并高尿酸血症患病风险的相加交互作用

, figureFileSmall=null, figureFileBig=null, tableContent=
项目高血压合并高尿酸血症患病数高血压合并高尿酸血症患病率/%单因素分析多因素分析
OR值95%CIOR值95%CI
低TyG且非超重/肥胖604.031.0001.000
高TyG且非超重/肥胖849.072.3761.688～3.3452.2771.613～3.214
低TyG且超重/肥胖153 7.701.9881.463～2.7012.0121.477～2.739
高TyG且超重/肥胖642 18.575.4304.136～7.1285.1593.916～6.796
低TyG且非中心型肥胖773.871.0001.000
高TyG且非中心型肥胖137 9.452.5951.946～3.4612.4861.860～3.323
低TyG且中心型肥胖136 9.172.5111.883～3.3492.3291.742～3.114
高TyG且中心型肥胖589 20.076.2474.889～7.9815.5874.357～7.164
低TyG且非高WHtR604.071.0001.000
高TyG且非高WHtR909.612.5081.789～3.5152.2211.579～3.125
低TyG且高WHtR153 7.651.9561.440～2.6572.0821.526～2.840
高TyG且高WHtR636 18.45 5.3404.067～7.0115.3264.038～7.026
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河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系
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唐丽娟 , 曹亚景 , 高金钗 , 岳福娟 , 高屹福 , 张帆 , 史卫卫 , 蒋东升 *, *
中国公共卫生 | 专题报道——健康生活方式，预防慢性病 2025,41(5): 539-545
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中国公共卫生 |专题报道——健康生活方式，预防慢性病 2025 , 41 (5) : 539 -545
河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系
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唐丽娟, 曹亚景, 高金钗, 岳福娟, 高屹福, 张帆, 史卫卫, 蒋东升*, *
作者信息
  • 河北省疾病预防控制中心慢性非传染性疾病防治所，石家庄 050021
通讯作者:
蒋东升，E-mail：
作者简介:

唐丽娟（1982—），副主任技师，博士，研究方向：慢性病预防与控制

Effect of TyG combined with obesity indicators on prevalence of hypertension and hyperuricemia comorbidity among residents aged 35 years and older in Hebei province: a surveillance data analysis
Lijuan TANG, Yajing CAO, Jinchai GAO, Fujuan YUE, Yifu GAO, Fan ZHANG, Weiwei SHI, Dongsheng JIANG
Affiliations
  • Institute of Chronic Non-communicable Diseases, Hebei Centre for Disease Control and Prevention, Shijiazhuang 050021, China
    • Corresponding Author:
    JIANG Dongsheng, E-mail:
出版时间: 2025-05-10 doi: 10.11847/zgggws1146116
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摘要
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目的

了解河北省≥35岁居民三酰甘油–葡萄糖乘积指数（TyG）和不同肥胖指标与高血压合并高尿酸血症患病的关系，为该地区居民高血压合并高尿酸血症的防治提供参考依据。

方法

收集2020年4—12月河北省心血管病及其危险因素监测项目10个监测点调查中7 859名≥35岁常住居民的相关数据，应用多因素非条件logistic回归模型分析TyG和超重/肥胖、中心型肥胖、腰高比（WHtR）等不同肥胖指标与高血压合并高尿酸血症患病的关系，计算TyG与不同肥胖指标对高血压合并高尿酸血症患病的相加交互作用，并采用受试者工作特征（ROC）曲线下面积（AUC）评估TyG和不同肥胖指标对高血压合并高尿酸血症患病的预测价值。

结果

河北省纳入分析的7 859名≥35岁居民中，非超重/肥胖者2 415人（30.73%），超重/肥胖者5 444人（69.27%）；非中心型肥胖者3 442人（43.80%），中心型肥胖者4 417人（56.20%）；非高WHtR者2 413人（30.70%），高WHtR者5 446人（69.30%）；低TyG（≤8.42）者3 475人（44.22%），高TyG（≥8.43）者4 384人（55.78%）；患高血压合并高尿酸血症者939例，高血压合并高尿酸血症患病率为11.95%。在调整了性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况和是否糖尿病等混杂因素后，多因素非条件logistic回归分析结果显示，河北省≥35岁中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁非中心型肥胖居民的1.676倍（OR=1.676，95%CI=1.346～2.087），≥35岁超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁非超重/肥胖居民的1.440倍（OR=1.440，95%CI=1.148～1.807），≥35岁高WHtR居民高血压合并高尿酸血症患病风险为≥35岁非高WHtR居民的1.297倍（OR=1.297，95%CI=1.001～1.679），≥35岁高TyG居民高血压合并高尿酸血症患病风险为≥35岁低TyG居民的2.335倍（OR=2.335，95%CI=1.974～2.763）；TyG与不同肥胖指标对高血压合并高尿酸血症患病均存在相加交互作用，≥35岁高TyG且超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非超重/肥胖居民的5.159倍（OR=5.159，95%CI=3.916～6.796），≥35岁高TyG且中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非中心型肥胖居民的5.587倍（OR=5.587，95%CI=4.357～7.164），≥35岁高TyG且高WHtR居民高血压合并高尿酸血症患病风险为≥35岁低TyG且非WHtR居民的5.326倍（OR=5.326，95%CI=4.038～7.026）；ROC分析结果显示，TyG+腰围（WC）对高血压合并高尿酸血症的预测效力优于TyG+体质指数（BMI）、TyG+WHtR和单一TyG指标，AUC为0.725（95%CI=0.715～0.735）。

结论

高TyG、超重/肥胖、中心型肥胖和高WHtR均可增加河北省≥35岁居民高血压合并高尿酸血症的患病风险，且TyG与不同肥胖指标间存在相加交互作用，可将TyG+WC作为预测高血压合并高尿酸血症患病的有效指标。

高血压合并高尿酸血症  /  三酰甘油–葡萄糖乘积指数（TyG）  /  超重/肥胖  /  中心型肥胖  /  腰高比（WHtR）  /  关系  /  ≥35岁居民  /  河北省
Objective

To investigate the effect of the triglyceride-glucose index (TyG) combined with various obesity indicators on the prevalence of comorbid hypertension and hyperuricemia among residents aged 35 years and older in Hebei province, and to provide a reference for the prevention and treatment of this comorbidity in the population.

Methods

Data from 7 859 permanent residents aged 35 years and older were collected as part of the Cardiovascular Disease and Risk Factor Surveillance Project, conducted in 10 districts/counties/cities of Hebei province between April and December 2020. A multivariable logistic regression model was used to analyze the relationship between the TyG, overweight/obesity, central obesity, and waist-to-height ratio (WHtR) with the prevalence of comorbid hypertension and hyperuricemia. The additive interaction between TyG and different obesity indicators on the prevalence of comorbid hypertension and hyperuricemia was assessed using relative excess risk due to interaction (‌RERI). The predictive value of TyG and different obesity indicators for comorbid hypertension and hyperuricemia was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results

Among 7 859 surveyed residents, 30.73% (2 415) were non-overweight/obese, while 69.27% (5 444) were overweight/obese; 43.80% (3 442) were non-centrally obese, and 56.20% (4 417) were centrally obese; 30.70% (2 413) had a normal WHtR, and 69.30% (5 446) had a high WHtR; 44.22% (3 475) had a low TyG (≤ 8.42), and 55.78% (4 384) had a high TyG (≥ 8.43). Additionally, 11.95% (939) had comorbid hypertension and hyperuricemia. After adjusting for sex, age, education, residence, physical activity, current smoking, alcohol consumption, and diabetes, multivariable logistic regression analysis revealed a significantly increased risk of comorbid hypertension and hyperuricemia among residents with central obesity (odds ratio [OR] = 1.676, 95% confidence interval [95%CI]: 1.346 - 2.087), overweight or obesity (OR = 1.440, 95%CI: 1.148 - 1.807), high WHtR (OR = 1.297, 95%CI: 1.001 - 1.679), and high TyG (OR = 2.335, 95%CI: 1.974 - 2.763), compared to residents who were not centrally obese, not overweight or obese, had normal WHtR, and had low TyG. The multivariable logistic regression results also showed significantly higher risks of comorbid hypertension and hyperuricemia among residents with both high TyG and high obesity indicators, including overweight or obesity (OR = 5.159, 95%CI: 3.916 - 6.796), central obesity (OR = 5.587, 95%CI: 4.357 - 7.164), and high WHtR (OR = 5.326, 95%CI: 4.038 - 7.026), compared to residents with low TyG and no overweight or obesity, no central obesity, and low WHtR, indicating an additive interaction between TyG and obesity indicators in comorbid hypertension and hyperuricemia. ROC analysis demonstrated that TyG combined with waist circumference (WC) had a higher predictive power for comorbid hypertension and hyperuricemia (AUC = 0.725, 95%CI: 0.715 - 0.735), indicating better diagnostic accuracy compared to TyG combined with body mass index (BMI), TyG combined with WHtR, or TyG alone.

Conclusions

High TyG, overweight/obesity, central obesity, and high WHtR are all associated with an increased risk of hypertension combined with hyperuricemia in residents aged 35 years and older in Hebei province. An additive interaction exists between TyG and different obesity indicators. TyG combined with WC could serve as an effective predictor for hypertension combined with hyperuricemia.

hypertension combined with hyperuricemia  /  triglyceride-glucose index  /  overweight/obesity  /  central obesity  /  waist-to-height ratio  /  relationship  /  residents aged ≥35 years  /  Hebei province
唐丽娟, 曹亚景, 高金钗, 岳福娟, 高屹福, 张帆, 史卫卫, 蒋东升. 河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系. 中国公共卫生, 2025 , 41 (5) : 539 -545 . DOI: 10.11847/zgggws1146116
Lijuan TANG, Yajing CAO, Jinchai GAO, Fujuan YUE, Yifu GAO, Fan ZHANG, Weiwei SHI, Dongsheng JIANG. Effect of TyG combined with obesity indicators on prevalence of hypertension and hyperuricemia comorbidity among residents aged 35 years and older in Hebei province: a surveillance data analysis[J]. Chinese Journal of Public Health, 2025 , 41 (5) : 539 -545 . DOI: 10.11847/zgggws1146116
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高血压是中国面临的一项重大公共卫生问题，随着人口老龄化的逐渐加剧，高血压的防治工作亦面临着巨大挑战。中国慢性病及危险因素监测数据显示，高血压患病率近十几年仍不断升高，从2004年的24.9%升高至2018年的38.1%[1]。此外，2015年的一项研究表明，中国高尿酸血症的患病率为13.3%且仍呈逐年上升趋势[2]。临床上高血压常与高尿酸血症共病，有研究数据显示，中国33 785例原发性高血压患者中，高尿酸血症的患病率达38.7%，其中男性和女性的患病率分别为35.1%和45.2%[3]。高血压与高尿酸血症常常相互作用、相互影响，且二者均会增加心脑血管疾病的患病风险[4–5]，因此，探寻高血压合并高尿酸血症的危险因素，确定有效的防控点，在心脑血管疾病的早期预防和控制工作中十分重要。既往研究表明，肥胖与高血压或高尿酸血症均密切相关[6–7]，但与二者共病关系的研究却较少。近年有研究发现，三酰甘油–葡萄糖乘积指数（triglyceride-glucose index，TyG）作为胰岛素抵抗替代生物指标，可预测心血管病风险[8]。一项meta分析结果显示TyG与新发高血压存在显著关联[9]，在中国人群中亦发现其与高血压患病风险独立相关[10]，但TyG是否与高血压和高尿酸血症共病存在关联，尚少见报道。为了解河北省≥35岁居民TyG和不同肥胖指标与高血压合并高尿酸血症患病的关系，为该地区居民高血压合并高尿酸血症的防治提供参考依据，本研究收集2020年4—12月河北省心血管病及其危险因素监测项目10个监测点调查中7 859名≥35岁常住居民的相关数据，应用多因素非条件logistic回归模型分析TyG和超重/肥胖、中心型肥胖、腰高比（waist-to-height ratio，WHtR）等不同肥胖指标与高血压合并高尿酸血症患病的关系，计算TyG与不同肥胖指标对高血压合并高尿酸血症患病的相加交互作用，并采用受试者工作特征（receiver operating characteristic，ROC）曲线下面积（area under the curve，AUC）评估TyG和不同肥胖指标对高血压合并高尿酸血症患病的预测价值。结果报告如下。
1　资料与方法
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1.1　资料来源
收集2020年4—12月河北省心血管病及其危险因素监测项目中石家庄市晋州市、保定市莲池区、沧州市新华区、承德市双滦区、廊坊市大城县、邯郸市邯山区、邢台市内丘县、衡水市故城县、唐山市玉田县和定州市10个监测点调查的7 859名≥35岁常住居民相关数据，内容包括性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况、是否糖尿病、是否高血压、是否高尿酸血症、是否超重/肥胖、是否中心型肥胖、是否高WHtR和TyG等。其中，身体活动充足指累计中等活动（引起呼吸、心跳轻度增加的活动[11]）≥150分/周[12]；现在吸烟指调查对象在30 d内有过吸烟行为，即使只吸1支烟[13]；现在饮酒指调查对象1个月内有过饮酒行为，过去饮酒指调查对象1个月前有过饮酒行为[14]；糖尿病指既往被诊断为糖尿病或空腹血糖≥7.0 mmol/L[15]；高血压指收缩压≥140 mmHg（1 mmHg=0.133 3 kPa）和/或舒张压≥90 mmHg，或既往被诊断为高血压[16]；高尿酸血症指空腹血尿酸水平男性≥7 mg/dL、女性≥6 mg/dL[17]；超重/肥胖通过计算体质量指数（body mass index，BMI）判定，BMI=体重（kg）/[身高（m）]2，其中BMI 24.0～27.9为超重，≥28.0为肥胖[18]；中心型肥胖指男性腰围（waist circumference，WC）≥90 cm、女性WC≥85 cm[19]；WHtR指WC与身高的比值，男性≥0.53、女性≥0.5为高WHtR[20]；TyG=ln[甘油三酯（mg/dL） ×空腹血糖（mg/dL）/2]，本研究按四分位数分为Q1（≤7.95）、Q2（7.96～8.42）、Q3（8.43～8.95）和Q4（>8.95），低TyG指Q1+Q2，高TyG指Q3+Q4[20]。本研究项目经阜外医院伦理审查委员会审查批准（批号：Approval No.2020-1360），且所有调查对象均签署了知情同意书。
1.2　统计分析
应用SPSS 29.0统计软件进行一般描述分析、χ2检验和多因素非条件logistic回归分析；采用Andersson T等[21]编制的 Excle表计算交互作用超额相对危险度（relative excess risk due to interaction，‌RERI）、归因比（attributable proportion due to interaction，‌AP）和协同指数（synergy index，‌SI）3个评价相加交互作用的指标，如RERI 和AP的95%CI不包含0且SI的95%CI不包含1，则两因素之间存在相加交互效应；采用ROC曲线的AUC评估不同指标对高血压合并高尿酸血症患病的预测能力，AUC的比较通过MedCal 20.0软件实现。检验水准为双侧检验α=0.05。
2　结　果
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2.1　一般情况
河北省纳入分析的7 859名≥35岁居民中，男性3 781人（48.11%），女性4 048人（51.89%）；年龄35～44岁居民2 371人（30.17%），45～54岁2 003人（25.49%），55～64岁1 449人（18.44%），65～74岁1 065人（13.55%），≥75岁971人（12.36%）；文化程度初中及以下6 028人（76.70%），高中1 260人（16.03%），大专及以上571人（7.27%）；居住在城市3 213人（40.88%），农村4 646人（59.12%）；身体活动不充足者2 177人（27.70%），充足者5 682人（72.30%）；现在不吸烟者5 970人（76.06%），现在吸烟者1 879人（23.94%）；过去和现在均不饮酒者5 205人（66.31%），过去饮酒但现在不饮酒者639人（8.14%），过去和现在均饮酒者2 005人（25.54%）；非糖尿病者6 817人（86.74%），糖尿病者1 042例（13.26%）；非超重/肥胖者2 415人（30.73%），超重/肥胖者5 444人（69.27%）；非中心型肥胖者3 442人（43.80%），中心型肥胖者4 417人（56.20%）；非高WHtR者2 413人（30.70%），高WHtR者5 446人（69.30%）；低TyG者3 475人（44.22%），高TyG者4 384人（55.78%）。
2.2　河北省中老年居民高血压合并高尿酸血症患病情况（表1）
河北省纳入分析的7 859名≥35岁居民中，患高血压合并高尿酸血症者939例，患病率为11.95%。河北省不同特征≥35岁居民比较，不同性别、年龄、文化程度、居住地、饮酒情况、是否现在吸烟、TyG及是否糖尿病、超重/肥胖、中心型肥胖、高WHtR≥35岁居民高血压合并高尿酸血症患病率不同，差异均有统计学意义（均P<0.05）。
2.3　河北省≥35岁居民TyG指数和不同肥胖指标与高血压合并高尿酸血症患病关系
在调整了性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况和是否糖尿病等混杂因素后，多因素非条件logistic回归分析结果显示，河北省≥35岁中心型肥胖居民高血压合并高尿酸血症患病风险为≥35岁非中心型肥胖居民的1.676倍（OR=1.676，95%CI=1.346～2.087），≥35岁超重/肥胖居民高血压合并高尿酸血症患病风险为≥35岁非超重/肥胖居民的1.440倍（OR=1.440，95%CI=1.148～1.807），≥35岁高WHtR居民高血压合并高尿酸血症患病风险为≥35岁非高WHtR居民的1.297倍（OR=1.297，95%CI=1.001～1.679），≥35岁高TyG居民高血压合并高尿酸血症患病风险为≥35岁低TyG居民的2.335倍（OR=2.335，95%CI=1.974～2.763）。
2.4　TyG和不同肥胖指标对高血压合并高尿酸血症患病风险的相加交互作用（表2）
TyG和不同肥胖指标间对高血压合并高尿酸血症的患病风险均存在交互作用，且每2个暴露因素同时存在时高血压合并高尿酸血症的患病风险均高于2个暴露因素单独存在时高血压合并高尿酸血症的患病风险之和：在调整了性别、年龄、文化程度、居住地、是否身体活动充足、是否现在吸烟、饮酒情况和是否糖尿病等混杂因素后，多因素非条件logistic回归分析结果显示，≥35岁高TyG且超重/肥胖居民高血压合并高尿酸血症的患病率为18.57%，其患病风险为≥35岁低TyG且非超重/肥胖居民的5.159倍（OR=5.159，95%CI=3.916～6.796），2个暴露因素对共病的患病具有相加交互作用（RERI=1.871，95%CI=1.081～2.662），且有36.3%的患病风险归因于二者的相加交互作用 （AP=0.363，95%CI=0.223～0.502），协同效应为二者单独存在产生效应之和的1.817倍（SI=1.817，95%CI=1.305～2.531）；≥35岁高TyG且中心型肥胖居民高血压合并高尿酸血症的患病率为20.07%，其患病风险为≥35岁低TyG且非超重/肥胖居民的5.587倍（OR=5.587，95%CI=4.357～7.164），2个暴露因素对共病的患病具有相加交互作用（RERI=1.770，95%CI=0.977～2.562），且有31.7%的患病风险归因于二者的相加交互作用 （AP=0.317，95%CI=0.188～0.446），协同效应为二者单独存在产生效应之和的1.629倍（SI=1.629，95%CI=1.251～2.120）；≥35岁高TyG且高WHtR居民高血压合并高尿酸血症的患病率为18.45%，其患病风险为≥35岁低TyG且非超重/肥胖居民的5.326倍（OR=5.326，95%CI=4.038～7.026），2个暴露因素对共病的患病具有相加交互作用（RERI=2.026，95%CI=1.252～2.800），且有38.0%的患病风险归因于二者的相加交互作用（AP=0.380，95%CI=0.253～0.508），协同效应为二者单独存在产生效应之和的1.880倍（SI=1.880，95%CI=1.375～2.571）。
2.5　TyG和不同肥胖指标预测高血压合并高尿酸血症患病的ROC曲线分析
分别分析TyG和不同肥胖指标以及它们的联合指标对高血压合并高尿酸血症的预测效力，ROC曲线分析结果显示，单一指标TyG、WC、BMI和WHtR均对高血压合并高尿酸血症有一定预测作用，其AUC分别为0.677（95%CI=0.667～0.688）、0.690（95%CI=0.679～0.700）、0.659（95%CI=0.648～0.669）和0.661（95%CI=0.650～0.671），与TyG比较，WC、BMI和WHtR的对高血压合并高尿酸血症的预测效力与TyG的差异均无统计学意义（均P>0.05）；TyG+WC、TyG+BMI和TyG+WHtR联合指标亦均对高血压合并高尿酸血症有一定预测作用，其AUC分别为0.725（95%CI=0.715～0.735）、0.708（95%CI=0.698～0.718）和0.712（95%CI=0.702～0.722），与TyG+BMI、TyG+WHtR联合指标和单一TyG指标比较，TyG+WC联合指标的预测效力最优且差异均有统计学意义（均P＜0.001）。
3　讨　论
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有研究表明，高血压和高尿酸血症作为临床常见的病症，二者协同作用会增加心脑血管病的患病风险[4–5]并引发肾脏损伤[22]，从而增加疾病的经济和社会负担。既往研究表明，2009年中国≥45岁中老年人群最常见的慢性病共病为高血压合并高尿酸血症，其患病率达13.3%[23]。本研究结果显示，河北省≥35岁居民中高血压合并高尿酸血症的患病率略低于全国水平，为11.95%，但高血压合并高尿酸血症流行形势依然严峻，因此，探寻高血压合并高尿酸血症相关危险因素和有效简便易行的预测指标，以及找准防控抓点在疾病防控的实践工作中十分必要。
已有研究结果表明，在中老年人群中，肥胖与高血压或高尿酸血症均密切相关[24–25]，国际上通常用BMI和WC作为肥胖程度衡量指标，陈冯梅等[26]进行的一项队列研究发现，除BMI和WC外，WHtR作为描述脂肪聚集性分布的指标，亦与高血压的发病风险相关，因此本研究采用BMI、WC和WHtR分别分析了超重/肥胖、中心型肥胖和高WHtR与高血压合并高尿酸血症患病的关系，多因素非条件logistic回归结果显示BMI、WC和WHtR 3个肥胖指标均会增加高血压和高尿酸血症的共病患病风险，Li Q等[27]的队列研究结果显示，高BMI值（>28.0）与高血压患者并发高尿酸血症的风险独立相关，与本研究结果相似，但其并未发现中心型肥胖与高血压患者并发高尿酸血症的相关性，这可能是因为Li Q等[27]的研究对象为高血压人群，而本研究对象为≥35岁全人群；Wang C Y等[28]的队列研究结果亦显示，中国居民的BMI在高尿酸血症并发高血压中具有中介效应，与本研究结果相似。江西省的一项横断面研究发现，WHtR≥0.5为高血压患者并发高尿酸血症的重要危险因素[29]，与本研究结果亦相似。
肥胖引起的胰岛素抵抗问题与高血压合并高尿酸血症密切相关[30–31]，TyG作为评估胰岛素抵抗的重要指标，本研究将其与高血压合并高尿酸血症的关系进行了分析，结果显示，河北省≥35岁居民中，高TyG人群患高血压合并高尿酸血症的风险会增加1.335倍（OR=2.335，95%CI=1.974～2.763），Li Y等[32]对1999—2018年美国国家健康和营养调查中收集成年人数据进行的分析结果亦发现TyG与高血压合并高尿酸血症呈显著相关。进一步分析TyG与不同肥胖指标对高血压合并高尿酸血症相加交互作用结果显示，TyG分别与BMI、WC和WHtR间存在交互作用，这与既往研究结果相似，在我国40～75岁的高血压患者中，TyG与高尿酸血症的患病风险显著相关，且BMI和WC在起中介效应[33]。
本研究进一步分析TyG和不同肥胖指标及其联合指标对高血压合并高尿酸血症患病风险的预测效力，结果发现单一指标TyG对高血压合并高尿酸血症共病患病具有一定预测作用，与既往研究中TyG对于单病或共病均有预测作用的结果一致[34–36]。但TyG联合不同肥胖指标后，因地域、民族和年龄结构不同，其对疾病的预测结果不尽一致，本研究的ROC曲线分析发现，TyG+WC对共病的预测效力优于单一指标、TyG+BMI和TyG+WHtR，而田英杰等[37]的研究表明TyG+WHtR在蒙古族居民中能更好地评估高血压风险，山东省青岛市大学生的一项研究表明TyG+BMI对高尿酸血症的预测效力最好[38]，江西省一项针对高血压患者的研究则显示TyG与高尿酸血症的关联性更强[36]。
综上所述，河北省≥35岁居民高TyG、超重/肥胖、中心型肥胖和高WHtR均可增加高血压合并高尿酸血症的患病风险，且TyG与不同肥胖指标间存在相加交互作用，可作为疾病的防控的重要抓点。此外，结合该地区居民的个体情况和临床指标，推荐将TyG+WC作为预测高血压合并高尿酸血症患病的辅助指标。但本研究仍存在一定的局限性：首先，本研究为横断面研究，不能判断TyG和不同肥胖指标与高血压合并高尿酸血症患病的因果关系；其次，本研究在调查中并未将患者服用降压和降脂药的情况纳入分析，可能对调查结果产生一定影响，因此在后续的研究中将充分考虑可能的影响因素进行进一步队列研究，从而对本研究结果加以验证。

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2025年第41卷第5期
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doi: 10.11847/zgggws1146116
  • 接收时间：2024-10-10
  • 首发时间：2026-10-25
  • 出版时间：2025-05-10
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  • 收稿日期：2024-10-10
  • 修回日期：2024-12-14
  • 录用日期：2025-04-02
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    河北省疾病预防控制中心慢性非传染性疾病防治所，石家庄 050021

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蒋东升，E-mail：
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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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