Evaluation of the Relationship between Non-insulin-based indexes of Insulin resistance andHypertension among non-diabetic Adult population of Bandare-Kong cohort, a PopulationbasedCross-sectional Study

Introduction: Insulin resistance (IR)is defined as a biological response lower than expected to a specificconcentration of the insulin hormone, and this condition plays a crucial role in the development of type ۲diabetes mellitus. The use of fasting insulin as an indicator for routine measurement is limited. In light of thislimitation, some researchers have created several alternative indices for evaluating IR that do not rely on insulinlevels. The study aimed to assess the relationship between triglycerides to high-density lipoprotein cholesterolratio (TG/HDL-C), the glucose-triglyceride index (TyG index) and Metabolic Score for Insulin Resistance(METS-IR), and hypertension.Method and materials: This study used data from adults who received a routine physical examination on theBandare Kong cohort database. Because the three non‐insulin‐based IR indexes to be explored in this studycontained fasting plasma glucose (FPG) and lipid parameters, to avoid medication interference, we excludedpeople who self‐reported using lipid‐lowering medications or antidiabetic drugs. Additionally, pregnant andbreastfeeding women, individuals with a history of alcohol use, any form of cancer, chronic liver disease, orkidney disease, and those using immunosuppressive drugs, oral or intravenous corticosteroids were alsoexcluded.Results: The averages of all three non-insulin-based indexes were significantly higher in the hypertensive group(P<۰.۰۰۱). After controlling for age, METS_IR and TyG-index showed positive correlations with SBP and DBPin both male and female groups (all P < ۰.۰۰۱); however, the strength of the correlation between TG to HDLratio with SBP and DBP was seen to be stronger in women than in men. In multivariable logistic regressionmodels for females, all non-insulin-based indexes of IR were significantly associated with hypertension.However, for men, it was not seen a significant association between TG/HDL-C and hypertension. Overall, thehighest odds of HTN were associated with the TyG index in both sexes. After adjusting the effects of othervariables, for a one-unit increase in METS_IR, the odds of hypertension increased by ۰.۰۵ and ۰.۰۶ in men andfemales, respectively (AOR: ۱.۰۵; ۹۵%CI: ۱.۰۳-۱.۰۷, AOR: ۱.۰۶; ۹۵%CI: ۱.۰۵-۱.۰۸). Also, for a one-unitincrease in TyG-index, the odds of hypertension in men and women increased by about ۲ and ۶ times,respectively (AOR: ۲.۱۵; ۹۵%CI: ۱.۳۰-۳.۵۴, AOR: ۶.۰۲; ۹۵%CI: ۳.۵۲-۱۰.۲۹). Moreover, for a one-unit increasein TG/HDL-C, the odds of hypertension increased by ۰.۱۸ in females (AOR: ۱.۱۸; ۹۵%CI: ۱.۱۰-۱.۲۶).To evaluate the diagnostic ability of these indexes, we calculate the area under the ROC curve (AUC) for eachone; for females, the highest AUC was demonstrated by TyG (AUC = ۰.۶۴, cutoff values: ۴.۶۴), followed by Mets-IR (AUC = ۰.۶۲, cutoff values: ۳۹.۴۱). For males, TyG (AUC = ۰.۶۰, cutoff values: ۴.۶۳) and METS-IR(AUC = ۰.۶۰, cutoff values: ۳۷.۵۶) had almost the same ability to predict hypertension.Conclusion: This study demonstrated that all three non-insulin-based indexes exhibited an association withHTN, although gender disparities were observed. The correlation between TG to HDL ratio and HTN wasparticularly robust in females. Both sexes displayed the highest likelihood of HTN in relation to the TyG index,with females exhibiting a stronger association.

کلیدواژه ها:

Insulin resistance ، hypertension ، TyG index ، cohort