Higher TyG and TyG-BMI were associated with hypertension in Chinese children and adolescents, more strongly for TyG-BMI; machine-learning models built from routinely available variables showed only moderate discrimination and remain hypothesis-generating tools rather than validated prediction models.
Pediatric hypertension prevalence in the Henan Province sample was 6.95%.
Each 1-SD increase in the TyG index was associated with higher odds of hypertension in all adjusted models, with a graded association across quartiles.
TyG-BMI showed a stronger association with hypertension than TyG.
No multiplicative interaction survived multiple-testing correction, but additive-scale interactions were all positive.
Machine-learning models using TyG or TyG-BMI achieved moderate discrimination in the held-out validation set.
Adding TyG or TyG-BMI to a baseline model that already included BMI improved discrimination only marginally.
The authors characterize the machine-learning models as hypothesis-generating rather than validated prediction tools, and call for longitudinal studies.
This study looked at about 26,000 children and teenagers aged 7-17 in Henan Province, China, to see whether two simple markers linked to insulin resistance were related to high blood pressure. One marker (TyG) combines blood triglycerides and fasting blood sugar. The other (TyG-BMI) combines TyG with body mass index. About 7% of the children had high blood pressure. Children with higher TyG and higher TyG-BMI were more likely to have high blood pressure, even after accounting for other factors. The link was considerably stronger for TyG-BMI, which includes body size, than for TyG alone. There was some indication that these markers may work together with other risk factors to raise risk, but this was not conclusive. The researchers also tested whether computer-based machine-learning models could identify children with high blood pressure. Performance was only moderate, and adding TyG or TyG-BMI to a model that already included BMI barely improved it. This research suggests these markers are associated with pediatric hypertension but may add little beyond BMI for identifying affected children. Because the study captured a single point in time, it cannot show that these markers cause high blood pressure, and follow-up studies are needed.
Zhu J, Zhang C, Sun J, Du H, Zhao W, Tian G, et al.. (2026). Association between the triacylglycerol-glucose index, TyG-BMI and hypertension in children and adolescents: a cross-sectional study with machine-learning-based risk stratification.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1964709