Triglyceride and Glucose Index and Sex Differences in Relation to Cognitive Impairment in Hypertensive Patients without Diabetes

BackgroundPrevious observational studies in patients with diabetes have examined the relationship between insulin resistance (IR) and cognitive outcomes and failed to find that IR is associated with cognitive function. And the triglyceride-glucose (TyG) index, which measured serum triglyceride (TG) and fasting blood glucose (FBG), has been suggested as a surrogate reliable marker of IR and widely used due to its convenience and cost-effectiveness.However, to the best of our knowledge, the relationship between IR and intensive blood pressure control in specific cognitive outcomes has never been investigated. MethodsTo fill this knowledge gap, we analyzed the relationship between TYG levels and cognitive outcomes in hypertensive patients within the Systolic Blood Pressure Intervention Trial (SPRINT). The SPRINT evaluated the impact of intensive blood pressure control (systolic blood pressure < 120 mmHg) versus standard blood pressure control (systolic blood pressure < 140 mmHg). The Cox proportional risk regression was used to investigate the association between different TYG status and clinical outcomes. Additional stratified analyzes were performed to evaluate the robustness of gender difference. ResultsA total of 9,323 participants (6016 [64.53%] males and 3307 [35.47%] females) with hypertension from the SPRINT research were included in the analysis. The median follow-up period was 3.26 years. Our population was divided into three groups according to the size of the TyG index. The low TyG group was the reference. Sensitivity analyzes showed that in the SPRINT, the TyG index was significantly associated with the risk of cognitive outcomes across various subgroups. There was no significant interaction in the confounders. ConclusionsIn this cohort study, results suggest that patients with TyG levels higher had lower risk of probable dementia, but this study tested association, not causation. Our results demonstrated that in patients with hypertension, the association between TyG and risk of probable dementia is L-shaped.