Association of the triglyceride-glucose index with elevated somatic symptoms: a cross-sectional study in patients with hypertension
6 affiliations
- 1Department of Cardiology, The Affiliated Hospital of Qingdao University
- 2Xuzhou Medical University
- 3Department of Geriatrics, Xuzhou Cancer Hospital
- 4Department of Neurology, Xuzhou New Health Geriatric Hospital
- 5The Affiliated Hospital of Qingdao University
- 6The Affiliated Haici Hospital of Qingdao University, Qingdao Haici Hospital
Abstract
Background: Insulin resistance is a key component of cardiometabolic dysfunction and has been associated with adverse health outcomes. The triglyceride–glucose (TyG) index is a surrogate marker of insulin resistance. Elevated somatic symptoms are common but may be underrecognized among patients with hypertension. However, the association between TyG and elevated somatic symptoms remains unclear.
Methods: Patients with hypertension were consecutively recruited from the Affiliated Cardiovascular Hospital of Qingdao University between 2022 and 2023. Elevated somatic symptoms were assessed using the Chinese version of the Somatic Self-rating Scale (SSS-CN), with an SSS-CN score ≥30 defining elevated somatic symptoms. Multivariable regression models were used to evaluate the associations of TyG with elevated somatic symptoms. The incremental value of TyG beyond traditional clinical variables was assessed using model discrimination, reclassification, calibration, and decision curve analysis. Additive interaction analyses were performed to evaluate the joint effects of TyG with anxiety and depression. Sensitivity analyses were conducted to assess the robustness of the findings.
Results: Among 2,422 participants, 540 (22.3%) were classified as having elevated somatic symptoms. In fully adjusted models, TyG was positively associated with elevated somatic symptoms. Compared with Q1, the adjusted odds ratios for Q2–Q4 were 1.21 (95% CI: 0.89–1.64), 1.54 (95% CI: 1.15–2.08), and 1.87 (95% CI: 1.38–2.54), respectively. Adding TyG to traditional clinical variables improved model performance, with the area under the curve increasing from 0.704 (95% CI: 0.678–0.729) to 0.717 (95% CI: 0.692–0.742; DeLong test, P = 0.004). The addition of TyG also improved reclassification and discrimination (NRI = 0.3057, 95% CI: 0.2149–0.3955; IDI = 0.0143, 95% CI: 0.0080–0.0213; both P < 0.001). Statistically significant additive interactions were observed between elevated TyG and anxiety or depression in relation to elevated somatic symptoms. Sensitivity analyses yielded consistent results.
Conclusions: TyG was associated with elevated somatic symptoms among patients with hypertension, with additive interactions observed between TyG and anxiety or depression. TyG may provide additional information for assessing elevated somatic symptoms beyond traditional clinical variables.
Related
- Association between triglyceride glucose–relative fat mass index and obstructive sleep apnea risk : A cross-sectional study from NHANES
- Association between triglyceride-glucose index and total trabecular bone score in US adults : A cross-sectional study
- Association of the triglyceride-to-high-density lipoprotein cholesterol ratio with kidney stone status: cross-sectional and machine-learning analyses
- Association between triglyceride-glucose and fibrosis-4 indices and nephrolithiasis: a cross-sectional case-control study.
- Association Between Aerobic Physical Activity and Hypertension Among U.S. Adults: A Cross-Sectional Analysis of NHANES (National Health and Nutrition Examination Survey) 2021-2023
BibTeX
@article{teng2026association,
title = {{Association of the triglyceride-glucose index with elevated somatic symptoms: a cross-sectional study in patients with hypertension}},
author = {Tian-Qi Teng and Jing Liu and Meng-Meng Wang and Lei-Lei Bai and Zhi-Yi Yu and Zi-Shan Liu and Gui-Xia Sun and Hai-Chu Yu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1980534},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1980534/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of the triglyceride-glucose index with elevated somatic symptoms: a cross-sectional study in patients with hypertension
AU - Tian-Qi Teng
AU - Jing Liu
AU - Meng-Meng Wang
AU - Lei-Lei Bai
AU - Zhi-Yi Yu
AU - Zi-Shan Liu
AU - Gui-Xia Sun
AU - Hai-Chu Yu
PY - 2026
DA - 2026/11/09
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1980534
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1980534/full
AB - Background: Insulin resistance is a key component of cardiometabolic dysfunction and has been associated with adverse health outcomes. The triglyceride–glucose (TyG) index is a surrogate marker of insulin resistance. Elevated somatic symptoms are common but may be underrecognized among patients with hypertension. However, the association between TyG and elevated somatic symptoms remains unclear. Methods: Patients with hypertension were consecutively recruited from the Affiliated Cardiovascular Hospital of Qingdao University between 2022 and 2023. Elevated somatic symptoms were assessed using the Chinese version of the Somatic Self-rating Scale (SSS-CN), with an SSS-CN score ≥30 defining elevated somatic symptoms. Multivariable regression models were used to evaluate the associations of TyG with elevated somatic symptoms. The incremental value of TyG beyond traditional clinical variables was assessed using model discrimination, reclassification, calibration, and decision curve analysis. Additive interaction analyses were performed to evaluate the joint effects of TyG with anxiety and depression. Sensitivity analyses were conducted to assess the robustness of the findings. Results: Among 2,422 participants, 540 (22.3%) were classified as having elevated somatic symptoms. In fully adjusted models, TyG was positively associated with elevated somatic symptoms. Compared with Q1, the adjusted odds ratios for Q2–Q4 were 1.21 (95% CI: 0.89–1.64), 1.54 (95% CI: 1.15–2.08), and 1.87 (95% CI: 1.38–2.54), respectively. Adding TyG to traditional clinical variables improved model performance, with the area under the curve increasing from 0.704 (95% CI: 0.678–0.729) to 0.717 (95% CI: 0.692–0.742; DeLong test, P = 0.004). The addition of TyG also improved reclassification and discrimination (NRI = 0.3057, 95% CI: 0.2149–0.3955; IDI = 0.0143, 95% CI: 0.0080–0.0213; both P < 0.001). Statistically significant additive interactions were observed between elevated TyG and anxiety or depression in relation to elevated somatic symptoms. Sensitivity analyses yielded consistent results. Conclusions: TyG was associated with elevated somatic symptoms among patients with hypertension, with additive interactions observed between TyG and anxiety or depression. TyG may provide additional information for assessing elevated somatic symptoms beyond traditional clinical variables.
SN - 1664-2392
ER -