Metabolic biomarkers and cardiovascular risk stratification in hypertension

Abstract

Introduction: Cardiovascular risk calculators (CRC) are not locally validated and calibrated. Surrogate biomarkers of insulin resistance had identified subjects at higher risk of type 2 diabetes and cardiovascular disease.

Aim: Establish the frequency of surrogate biomarkers of insulin resistance and their correlation with CRC in primary prevention non-diabetic hypertensive subjects.

Methods: This is an observational registry with a prospective consecutive outpatient's sample. The TyG index (TyGi) was calculated as logarithm (Ln) of (fasting triglycerides [mg/dl]×fasting plasma glucose [mg/dl]/2). Patients were stratified according to quartiles of TyGi. Pearson correlation coefficient between TyGi and other relevant variables was evaluated.

Results: Four hundred six patients were included with a mean age 55.9±13 years, 231 p (56.9%) males. The mean TyGi was 8.667±0.53. Patients in the highest quartiles of TyGi had significantly higher median difference between expected and actual ASCVD risk (p=0.02), higher frequency of AHA/ACC Pooled Cohort Equation >7.5% (p<0.005), and higher levels of metabolic biomarkers such as median triglyceridemia/HDL cholesterol ratio (TG/HDL) (p<0.0005), glycaemia and A1C (p<0.001 and p=0.02, respectively). The correlation between TyGi and TG/HDL was highly significant (r=0.7076; r²=0.5007; p<0.0001), and intermediate with non-HDL cholesterol (r=0.4553, r²=0.2073; p<0.0001).

Conclusions: Non-diabetic hypertensive patients with high TyGi, a surrogate biomarker of insulin resistance, had a higher 10-year cardiovascular risk by AHA/ACC Pooled Cohort Equation. TyGi is statistically and significantly correlated with other biomarkers of insulin resistance. TyGi could be a reliable biomarker in clinical practice to stratify cardiovascular risk.

Keywords: Biomarcadores; Biomarkers; Cardiovascular risk; Hipertensión; Hypertension; Insulin resistance; Insulinorresistencia; Riesgo cardiovascular.