Insulin resistance is associated with the development of hypertension, whereas there were rare studies comparing various non-insulin based insulin resistance (NI-IR) indices for the possibility of hypertension among young and middle-aged adults. This cross-sectional study included a total of 4,080 military personnel, aged 18–50 years, without antihypertensive medications therapy in 2014. All subjects received annual health examinations for blood pressure (BP) measurements. Stage I isolated diastolic hypertension (IDH) and isolated systolic hypertension (ISH) and combined hypertension were respectively defined as systolic BP (SBP) < 130 mmHg/diastolic BP (DBP) 80–89 mmHg, SBP 130–139 mmHg/DBP < 80 mmHg, and SBP 130–139 mmHg/DBP 80–89 mmHg. The cut-off values of stage II hypertension for SBP and DBP were 140–159 mmHg and 90–99 mmHg, respectively. Four NI-IR indices included the serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio, TyG index, Metabolic Score for IR (METS-IR) and ZJU index which were defined according to their specific formula. Multiple logistic regression analysis with adjustments for age, sex, anthropometrics, substance use, kidney function, serum uric acid, atherogenic cholesterols and physical activity was performed to determine the associations. There were 1,024 subjects with hypertension (25.1%) in which 739 were stage I hypertension, and 285 were stage II hypertension. For total hypertension, there were an association with TyG and METS-IR indices [odds ratios (ORs) and 95% confidence intervals: 1.432 (1.215–1.688) and 1.553 (1.040–2.321), respectively]. For hypertension subtypes, TyG index was positively associated with overall, stage I, and stage II ISH [ORs: 1.447 (1.149–1.823), 1.317 (1.029–1.687), and 2.011 (1.351–2.994), respectively], while TG/HDL-C, METS-IR and ZJU indices were merely associated with stage II ISH [ORs: 1.053 (1.006–1.103), 3.001 (1.171–7.696) and 1.009 (1.000-1.017), respectively]. In addition, TyG and METS-IR indices were positively associated with stage II IDH [ORs: 1.813 (1.207–2.721) and 2.85 (1.080–7.520), respectively], and TyG index was also associated with combined hypertension [OR: 1.425 (1.007–1.833)]. Among young and middle-aged adults, insulin resistance assessed by the four NI-IR indices was positively associated with stage II ISH, while only TyG index had a significant association for both stage II IDH and combined hypertension.

中文翻译：

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成人军人各种胰岛素抵抗指标与高血压可能性的比较：CHIEF 研究

胰岛素抵抗与高血压的发生有关，但很少有研究比较各种非胰岛素抵抗（NI-IR）指标来判断青壮年患高血压的可能性。这项横断面研究共纳入了 4,080 名年龄在 18-50 岁的军人，他们在 2014 年没有接受过抗高血压药物治疗。所有受试者都接受了年度健康检查以测量血压 (BP)。 I期单纯舒张期高血压(IDH)、单纯收缩期高血压(ISH)和合并高血压分别定义为收缩压(SBP)<130mmHg/舒张压(DBP)80～89mmHg、SBP130～139mmHg/DBP<80毫米汞柱，收缩压 130–139 毫米汞柱/舒张压 80–89 毫米汞柱。 II 期高血压的 SBP 和 DBP 临界值分别为 140-159 mmHg 和 90-99 mmHg。四种NI-IR指数包括血清甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值、TyG指数、IR代谢评分（METS-IR）和ZJU指数，根据其具体公式定义。进行多元逻辑回归分析，调整年龄、性别、人体测量学、物质使用、肾功能、血清尿酸、致动脉粥样硬化胆固醇和体力活动，以确定相关性。高血压患者 1,024 人（25.1%），其中 I 期高血压 739 人，II 期高血压 285 人。对于总高血压，与 TyG 和 METS-IR 指数相关[比值比 (OR) 和 95% 置信区间：分别为 1.432 (1.215–1.688) 和 1.553 (1.040–2.321)]。对于高血压亚型，TyG 指数与总体、I 期和 II 期 ISH 呈正相关[OR：分别为 1.447 (1.149–1.823)、1.317 (1.029–1.687) 和 2.011 (1.351–2.994)]，而 TG/ HDL-C、METS-IR 和 ZJU 指数仅与 II 期 ISH 相关[OR：分别为 1.053 (1.006–1.103)、3.001 (1.171–7.696) 和 1.009 (1.000-1.017)]。此外，TyG和METS-IR指数与II期IDH呈正相关[OR：分别为1.813（1.207-2.721）和2.85（1.080-7.520）]，TyG指数还与合并高血压相关[OR：1.425（ 1.007–1.833)]。在青壮年中，四项NI-IR指数评估的胰岛素抵抗与II期ISH呈正相关，而只有TyG指数与II期IDH和合并高血压均呈显着相关。