Abstract
Introduction. The critical role of insulin resistance (IR) in the clustering of metabolic syndrome (MetS) in association with hormonal and metabolic parameters of perimenopause determines the need to search for informative IR biomarkers in the prognosis of arterial hypertension for early prevention of cardiometabolic diseases.
Objective: to evaluate the informativeness of the surrogate marker of insulin resistance, TyG index, in predicting hypertension based on the analysis of a perimenopausal normoglycemic cohort.
Patients and methods. Of 88 normoglycemic women aged 35–59 years, 58 women had hypertension and 30 were normotensive. The following were determined: waist circumference (WC), blood pressure, triglycerides (TG), HDL-C, insulin, follicle-stimulating hormone (FSH) and estradiol, fasting glucose, TyG index. Using SPSS (version 23), we estimated the median and (25%; 75%); intergroup differences using the Mann-Whitney test; comparison of proportions using Pearson's χ2; performed correlation analyses: Spearman's (R) and partial correlation (Rрс) to level out the influence of age; binary logistic regression was used to identify prognostic factors. ROC analysis was used to determine the cutoff point of the TYG indicator.
Results. The TyG index statistically significantly correlated with the spectrum of MetS and perimenopause parameters, most closely and stably with partial correlation with insulin, WC, HDL-C, duration of postmenopause, age depending on FSH. Using multiple logistic regression analysis, the following parameters were included in the model: age, insulin, WC, FSH, TyG; the TyG index statistically most significantly associated with the presence of hypertension (OR=22.089; p=0.007). Using ROC analysis, the cutoff point for TYG was determined - 8.7 conventional units with the optimal parameters of the diagnostic test (presence and absence of hypertension): AUC was 0.793 (95% CI: 0.694-0.892), p<0.0001; Se 74%, Sp 67%.
Conclusion. The surrogate indicator of insulin resistance, the TyG index, closely correlated with markers of MetS and perimenopause, being most significantly associated with the presence of hypertension. The cutoff point for TYG was 8.7 conventional units with optimal test parameters. The results of the partial correlation and the presence of age and FSH indices in the diagnostic model reflect a combination of chronological and reproductive aging in the dynamics of the menopausal transition.