Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.
- 1School of Public Health, Ningxia Medical University, Yinchuan, China.
- 2People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China.
- 3Ningxia Institute of Clinical Medicine, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.
Abstract
Background
Hypertension, diabetes, and dyslipidemia frequently co-occur, yet simple screening tools are lacking in resource-limited settings. The hypertriglyceridemic waist-to-height ratio (HTH/WH) phenotype has emerged as a potential indicator, but its utility for identifying the triple burden of hypertension, diabetes, and dyslipidemia remains underexplored, particularly in underdeveloped regions of China.Methods
This cross-sectional study included 10,796 adults (≥18 years) from the Ningxia Hui Autonomous Region, Northwest China. The HTH/WH phenotype was defined as triglycerides ≥1.7 mmol/L combined with waist-to-height ratio ≥0.5. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for the association between the HTH/WH phenotype and coexisting hypertension, diabetes, and dyslipidemia. Mixed graphical models were employed to characterize the network associations among the HTH/WH phenotype, the three cardiometabolic disorders, and modifiable lifestyle factors.Results
The prevalence of concurrent hypertension, diabetes, and dyslipidemia was 3.99% in Ningxia, exceeding the Northwest China regional average of 2.33%. The HTH/WH phenotype was present in 21.30% of the population and demonstrated a significant, dose-response association with the triple burden (adjusted OR = 5.29, 95% CI: 4.14-6.74), as well as with two diseases (adjusted OR = 5.12, 95% CI: 4.22-6.21) and one disease (adjusted OR = 1.97, 95% CI: 1.77-2.20). Factors independently associated with the triple burden included age ≥40 years, smoking, alcohol consumption, and elevated BMI (≥24 kg/m²), while higher education and married status were inversely protective. Mixed graphical modeling revealed the HTH/WH phenotype as a central bridge node (bridge strength = 0.67) within the metabolic disorder network, with strong direct connections to hypertension, diabetes, and dyslipidemia. BMI exhibited the highest bridge centrality (bridge strength = 1.72), followed by smoking (bridge strength = 0.32).Conclusions
In Ningxia Hui Autonomous Region, concurrent hypertension, diabetes, and dyslipidemia pose a substantial health burden among adults. The HTH/WH phenotype may serve as a practical risk assessment indicator for identifying high-risk individuals with this metabolic multimorbidity.
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BibTeX
@article{wu2026hypertriglyceridemic,
title = {{Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.}},
author = {Lanqiqi Wu and Jiaoyang Chen and Ting He and Ling Ma and Yin Cheng and Yining Liu and Jinyu Ma and Huitian Tong and Chao Shi},
journal = {Frontiers in endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1932657},
url = {https://europepmc.org/article/MED/42908745},
note = {CC BY},
}
RIS
TY - JOUR
TI - Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.
AU - Lanqiqi Wu
AU - Jiaoyang Chen
AU - Ting He
AU - Ling Ma
AU - Yin Cheng
AU - Yining Liu
AU - Jinyu Ma
AU - Huitian Tong
AU - Chao Shi
PY - 2026
DA - 2026/10/07
JO - Frontiers in endocrinology
DO - 10.3389/fendo.2026.1932657
UR - https://europepmc.org/article/MED/42908745
AB - Background Hypertension, diabetes, and dyslipidemia frequently co-occur, yet simple screening tools are lacking in resource-limited settings. The hypertriglyceridemic waist-to-height ratio (HTH/WH) phenotype has emerged as a potential indicator, but its utility for identifying the triple burden of hypertension, diabetes, and dyslipidemia remains underexplored, particularly in underdeveloped regions of China.Methods This cross-sectional study included 10,796 adults (≥18 years) from the Ningxia Hui Autonomous Region, Northwest China. The HTH/WH phenotype was defined as triglycerides ≥1.7 mmol/L combined with waist-to-height ratio ≥0.5. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for the association between the HTH/WH phenotype and coexisting hypertension, diabetes, and dyslipidemia. Mixed graphical models were employed to characterize the network associations among the HTH/WH phenotype, the three cardiometabolic disorders, and modifiable lifestyle factors.Results The prevalence of concurrent hypertension, diabetes, and dyslipidemia was 3.99% in Ningxia, exceeding the Northwest China regional average of 2.33%. The HTH/WH phenotype was present in 21.30% of the population and demonstrated a significant, dose-response association with the triple burden (adjusted OR = 5.29, 95% CI: 4.14-6.74), as well as with two diseases (adjusted OR = 5.12, 95% CI: 4.22-6.21) and one disease (adjusted OR = 1.97, 95% CI: 1.77-2.20). Factors independently associated with the triple burden included age ≥40 years, smoking, alcohol consumption, and elevated BMI (≥24 kg/m²), while higher education and married status were inversely protective. Mixed graphical modeling revealed the HTH/WH phenotype as a central bridge node (bridge strength = 0.67) within the metabolic disorder network, with strong direct connections to hypertension, diabetes, and dyslipidemia. BMI exhibited the highest bridge centrality (bridge strength = 1.72), followed by smoking (bridge strength = 0.32).Conclusions In Ningxia Hui Autonomous Region, concurrent hypertension, diabetes, and dyslipidemia pose a substantial health burden among adults. The HTH/WH phenotype may serve as a practical risk assessment indicator for identifying high-risk individuals with this metabolic multimorbidity.
SN - 1664-2392
ER -