Associations of insulin resistance-related metabolic indices with albuminuria in primary hypertension without diabetes: a retrospective cross-sectional study.
- 1Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
- 2Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Abstract
Background
Insulin resistance-related metabolic indices have been associated with albuminuria in general populations and in patients with diabetes, but evidence in patients with primary hypertension without diabetes remains limited. Whether mean arterial pressure (MAP) statistically accounts for part of these associations is unclear.Methods
We retrospectively analysed cross-sectional data from 509 hospitalised cardiology patients with primary hypertension without diabetes at a single tertiary centre who underwent urinary albumin-to-creatinine ratio (UACR) testing. Albuminuria was defined as a UACR ≥30 mg/g. Associations of the triglyceride-glucose body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), and triglyceride-glucose (TyG) index with albuminuria and log₁₀-transformed UACR were examined using multivariable logistic and linear regression. Restricted cubic splines (RCS) assessed the shape of the associations. Supplementary logistic models additionally adjusted for MAP, and exploratory indirect-effect analyses assessed statistical indirect components involving MAP.Results
Among the 509 participants, 99 (19.4%) had albuminuria. After multivariable adjustment, the odds ratios (ORs) for albuminuria per 1-SD increment in TyG-BMI, METS-IR, and the TyG index were 1.610 [95% confidence interval (CI), 1.262-2.055], 1.557 (95% CI, 1.215-1.995), and 1.436 (95% CI, 1.128-1.829), respectively. Corresponding Q4-vs.-Q1 ORs were 2.464 (95% CI, 1.228-4.943), 2.665 (95% CI, 1.268-5.600), and 2.137 (95% CI, 1.092-4.181), with overall categorical P-values of 0.018, 0.059, and 0.099, respectively. RCS analyses showed significant overall associations for all three indices, with no statistical evidence of departure from linearity. All three indices were positively associated with log₁₀-transformed UACR. After additional MAP adjustment, the continuous associations with albuminuria were attenuated but remained statistically significant for all three indices, whereas the overall tests across quartiles were not statistically significant for any of the three indices. Exploratory analyses suggested statistical indirect components involving MAP for TyG-BMI and METS-IR, but not for the TyG index.Conclusions
Higher TyG-BMI, METS-IR, and TyG index values were associated with albuminuria and higher UACR in patients with primary hypertension without diabetes. Exploratory analyses suggested statistical indirect components involving MAP for TyG-BMI and METS-IR, but did not establish temporal ordering or causal mediation.
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BibTeX
@article{zhuo2026associations,
title = {{Associations of insulin resistance-related metabolic indices with albuminuria in primary hypertension without diabetes: a retrospective cross-sectional study.}},
author = {Yan Zhuo and Pengjie Gao and Suining Xu and Suhang Shang and Yiran Yan and Kamila Kamili and Xiyang Li and Danni Wang and Jianfeng Han and Gang Tian},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1959589},
url = {https://europepmc.org/article/MED/42908850},
note = {CC BY},
}
RIS
TY - JOUR
TI - Associations of insulin resistance-related metabolic indices with albuminuria in primary hypertension without diabetes: a retrospective cross-sectional study.
AU - Yan Zhuo
AU - Pengjie Gao
AU - Suining Xu
AU - Suhang Shang
AU - Yiran Yan
AU - Kamila Kamili
AU - Xiyang Li
AU - Danni Wang
AU - Jianfeng Han
AU - Gang Tian
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1959589
UR - https://europepmc.org/article/MED/42908850
AB - Background Insulin resistance-related metabolic indices have been associated with albuminuria in general populations and in patients with diabetes, but evidence in patients with primary hypertension without diabetes remains limited. Whether mean arterial pressure (MAP) statistically accounts for part of these associations is unclear.Methods We retrospectively analysed cross-sectional data from 509 hospitalised cardiology patients with primary hypertension without diabetes at a single tertiary centre who underwent urinary albumin-to-creatinine ratio (UACR) testing. Albuminuria was defined as a UACR ≥30 mg/g. Associations of the triglyceride-glucose body mass index (TyG-BMI), metabolic score for insulin resistance (METS-IR), and triglyceride-glucose (TyG) index with albuminuria and log₁₀-transformed UACR were examined using multivariable logistic and linear regression. Restricted cubic splines (RCS) assessed the shape of the associations. Supplementary logistic models additionally adjusted for MAP, and exploratory indirect-effect analyses assessed statistical indirect components involving MAP.Results Among the 509 participants, 99 (19.4%) had albuminuria. After multivariable adjustment, the odds ratios (ORs) for albuminuria per 1-SD increment in TyG-BMI, METS-IR, and the TyG index were 1.610 [95% confidence interval (CI), 1.262-2.055], 1.557 (95% CI, 1.215-1.995), and 1.436 (95% CI, 1.128-1.829), respectively. Corresponding Q4-vs.-Q1 ORs were 2.464 (95% CI, 1.228-4.943), 2.665 (95% CI, 1.268-5.600), and 2.137 (95% CI, 1.092-4.181), with overall categorical P-values of 0.018, 0.059, and 0.099, respectively. RCS analyses showed significant overall associations for all three indices, with no statistical evidence of departure from linearity. All three indices were positively associated with log₁₀-transformed UACR. After additional MAP adjustment, the continuous associations with albuminuria were attenuated but remained statistically significant for all three indices, whereas the overall tests across quartiles were not statistically significant for any of the three indices. Exploratory analyses suggested statistical indirect components involving MAP for TyG-BMI and METS-IR, but not for the TyG index.Conclusions Higher TyG-BMI, METS-IR, and TyG index values were associated with albuminuria and higher UACR in patients with primary hypertension without diabetes. Exploratory analyses suggested statistical indirect components involving MAP for TyG-BMI and METS-IR, but did not establish temporal ordering or causal mediation.
SN - 2296-858X
ER -