The Role of Triglyceride-Glucose Index in the Prediction of the Development of Hypertension

Findings from a Community Cohort in Singapore




Diabetes Mellitus, Type 2, Triglycerides, Hypertension, Screening, Population Science


Objectives. Triglyceride-glucose index (TyGI) is an emerging surrogate marker of insulin resistance. We aim to explore the role of triglyceride-glucose index in the prediction of the development of hypertension.

Methodology. We conducted a retrospective cohort study that included 3,183 study participants identified from a community health screening programme who had no baseline hypertension and were then followed up after an average of 1.7 years. Cox proportional-hazard model was used to assess the association between risk of incident hypertension and TyGI in quartiles, while adjusting for demographics and clinical characteristics.

Results. Hypertension occurred in 363 study participants (11.4%). Those who developed hypertension had higher TyGI [8.6 (IQR 8.2-9.0)] than those who did not [8.2 (IQR 8.0-8.7)] (p<0.001). Significant association between TyGI and hypertension was observed in both the unadjusted and proportional hazard model [Quartile (Q)2, p=0.010; Q3, p<0.001 and Q4, p<0.001] and the model that adjusted for demographics (Q2, p=0.016; Q3, p=0.003; Q4, p<0.001). In the model adjusted for clinical covariates, the hazard of developing hypertension remained higher in TyGI Q4 compared to TyGI Q1(Hazard Ratio=2.57; 95% Confidence Interval: 1.71, 3.87). Increasing triglyceride-glucose index accounted for 16.4% of the association between increasing BMI and incident hypertension, after adjusting for age, gender, ethnicity and baseline HDL cholesterol (p<0.001).

Conclusion. Triglyceride-glucose index was an independent predictor of the development of hypertension. It may potentially be used as an inexpensive indicator to predict the development of hypertension and risk-stratify individuals to aid management in clinical practice.


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Author Biographies

Jonathon Khoo, Khoo Teck Puat Hospital, Singapore

Senior Executive, Clinical Research Unit

Serena Low, Khoo Teck Puat Hospital, Singapore

Consultant, Clinical Research Unit, Khoo Teck Puat Hospital, Singapore

Diabetes Center, Admiralty Medical Centre, Singapore,

Lee Kong Chian, School of Medicine, Nanyang University Hospital, Singapore

Bastari Irwan, Yishun Health, Singapore

Director, Population Health

Justin Tang, Khoo Teck Puat Hospital, Singapore

Consultant, Coronary Care Unit

Chee Fang Sum, Khoo Teck Puat Hospital, Singapore

Senior Consultant, Clinical Research Unit

Tavintharan Subramaniam, Khoo Teck Puat Hospital, Singapore

Senior Consultant, Clinical Research Unit

Su Chi Lim, Khoo Teck Puat Hospital, Singapore

Senior Consultant, Clinical Research Unit, Khoo Teck Puat Hospital, Singapore

Diabetes Centre, Admiralty Medical Centre, Singapore
Lee Kong Chian School of Medicine, Nanyang University Hospital, Singapore
Saw Swee Hock School of Public Health, National University of Singapore


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How to Cite

Khoo, J., Low, S., Irwan, B., Tang, J., Sum, C. F., Subramaniam, T., & Lim, S. C. (2023). The Role of Triglyceride-Glucose Index in the Prediction of the Development of Hypertension: Findings from a Community Cohort in Singapore. Journal of the ASEAN Federation of Endocrine Societies, 38(1), 62–67.



Original Articles