In 10,796 adults from Ningxia, Northwest China, the hypertriglyceridemic waist-to-height ratio (HTH/WH) phenotype was strongly and dose-dependently associated with coexisting hypertension, diabetes, and dyslipidemia, and the authors conclude it may serve as a practical risk assessment indicator for identifying high-risk individuals with this metabolic multimorbidity.
The prevalence of concurrent hypertension, diabetes, and dyslipidemia in Ningxia adults was 3.99%, higher than the Northwest China regional average of 2.33%.
The HTH/WH phenotype was present in 21.30% of the study population.
The HTH/WH phenotype was strongly associated with the triple burden of hypertension, diabetes, and dyslipidemia.
The HTH/WH phenotype was also associated with having two diseases and one disease, with the odds rising as the number of coexisting diseases increased.
Age ≥40 years, smoking, alcohol consumption, and BMI ≥24 kg/m2 were independently associated with higher odds of the triple burden, whereas higher education and married status were inversely associated.
In the mixed graphical model network, the HTH/WH phenotype acted as a central bridge node linking hypertension, diabetes, and dyslipidemia.
BMI had the highest bridge centrality in the network, followed by smoking.
The authors conclude that concurrent hypertension, diabetes, and dyslipidemia pose a substantial burden in Ningxia and that the HTH/WH phenotype may be a practical risk assessment indicator.
This study looked at 10,796 adults in the Ningxia region of Northwest China to see how often high blood pressure, diabetes, and abnormal blood fats occur together, and whether a simple marker could help flag people with all three. About 4% of adults had all three conditions, which is higher than the 2.3% average for Northwest China. The marker, called the hypertriglyceridemic waist-to-height ratio phenotype, means having both high triglycerides (a blood fat) and a waist measurement that is at least half of one's height. About 21% of participants had it. These people had about five times the odds of having all three conditions, and about five times the odds of having two of them, compared with those without the phenotype. The odds were about double for having one condition. Older age (40 and over), smoking, drinking alcohol, and higher body mass index were linked to higher odds of the triple burden, while higher education and being married were linked to lower odds. A network analysis suggested the phenotype sits at a central point connecting the three conditions, and that body mass index and smoking were the lifestyle-related factors most strongly bridging them. This research suggests that a simple measure using a tape measure and a blood test could help identify people at high risk of multiple metabolic conditions in places with limited resources. Because the study is cross-sectional, it shows associations at one point in time and cannot show that the phenotype causes these conditions.
Wu L, Chen J, He T, Ma L, Cheng Y, Liu Y, et al.. (2026). Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1932657