Evidence map›Paper›PMID 42251024›Full record

ArticleScientific reports2026

Sex-specific performance of composite metabolic-adiposity indices in identifying hypertension and carotid atherosclerosis: a cross-sectional study of 154,873 Chinese adults.

Xiaoqian Dong, Xue He, Yinglong Duan, Sha Wang, Xingxing Wang, Nandan Chen, Zitong Lu, Ying Li, Lijun Li, Honglian Zhang

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In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Xiaoqian Dong *Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Xue He *Health Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Yinglong DuanNursing Department, Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Sha WangNursing Department, Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Xingxing WangXiangya School of Nursing, Central South University, Changsha, 410013, China.
Nandan ChenXiangya School of Nursing, Central South University, Changsha, 410013, China.
Zitong LuNursing Department, Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Ying LiHealth Management Medicine Center, The Third Xiangya Hospital, Central South University, Changsha, 410013, China.
Lijun LiSchool of Psychological Sciences, Monash University, Melbourne, 3800, Australia.
Honglian ZhangNursing Department, Third Xiangya Hospital, Central South University, Changsha, 410013, China. hlzhang_xy3yy@163.com.

Funding

the Special Funding for the Construction of Innovative Provinces in Hunan No.2020SK2091
6 · The paper itself

Abstract

The comparative superiority among the triglyceride-glucose (TyG) index and its obesity-related composite indicators in identifying hypertension and carotid atherosclerosis (CAS) remains unknown. This study aims to evaluate and compare the discriminative ability of these indices in a large-scale population to identify the optimal marker for cardiovascular risk assessment. This cross-sectional study included 154,873 participants who underwent routine physical examinations and carotid ultrasonography. Binary logistic regression, restricted cubic spline (RCS), receiver operating characteristic (ROC) analyses, and mediation analyses were used to evaluate the associations of TyG, TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), and TyG-body mass index (TyG-BMI) with hypertension and CAS. The mean age of participants was 45.7 ± 12.5 years, with 42.1% being female and 91.0% being married. A total of 16,235(10.5%) participants had hypertension, and 81,337 (52.5%) had CAS. Comparing the highest to the lowest quartile, TyG-WHtR demonstrated the strongest association with hypertension (OR = 8.644, 95% CI: 7.927-9.426) and CAS (OR = 2.173, 95% CI: 2.086-2.263). RCS analyses revealed monotonic increases for hypertension and complex nonlinear patterns for CAS. Stratified analyses revealed distinct phenotypic signatures. For hypertension, risk magnitudes were markedly amplified in younger adults (≤ 60 years) (P for interaction < 0.001 for all indices). For CAS, a significant interaction between sex and the indices was observed (P for interaction < 0.05 for TyG, TyG-WHtR, and TyG-BMI): TyG-WHtR exhibited the strongest association in women (OR = 1.504), whereas in men, the isolated TyG index was inversely associated with CAS, and only TyG-BMI showed a significant positive association (OR = 1.091). Mediation analyses revealed that obesity indicators (WHtR, BMI) demonstrated substantial direct associations with on outcomes, with TyG providing negligible or partial mediation, which may account for the stronger associations observed with composite indices. TyG-obesity composite indices are strongly associated with hypertension and CAS, particularly in younger adults. TyG-WHtR is optimal for women and the general population, while TyG-BMI is superior for men. These easily accessible and cost-effective metrics can serve as practical tools for early cardiovascular risk screening in primary care. Implementing such age-targeted and sex-specific risk stratification could facilitate more precise and timely preventive interventions.

Indexed as

AdiposityCarotid Artery DiseasesHypertensionAdultBlood GlucoseBody Mass IndexChinaCross-Sectional StudiesEast Asian PeopleFemaleHumansMaleMiddle AgedObesityRisk FactorsSex FactorsBlood GlucoseTriglyceridesCarotid atherosclerosisHypertensionMediation analysisMetabolic biomarkersObesityTriglyceride glucose

Identifiers

PMID42251024
PMCPMC13482543

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.