Hypertriglyceridemic waist-to-height ratio and the triple burden of hypertension, diabetes, and dyslipidemia in adults: association and network analysis.

Authors

Lanqiqi Wu, Jiaoyang Chen, Ting He, Ling Ma, Yin Cheng, Yining Liu, Jinyu Ma, Huitian Tong, Chao Shi

Published in

Frontiers in endocrinology. Volume 17. Pages 1932657. Epub Oct 07, 2026.

Abstract

Hypertension, diabetes, and dyslipidemia frequently co-occur, yet simple screening tools are lacking in resource-limited settings. The hypertriglyceridemic waist-to-height ratio (HTH/WH) phenotype has emerged as a potential indicator, but its utility for identifying the triple burden of hypertension, diabetes, and dyslipidemia remains underexplored, particularly in underdeveloped regions of China.
This cross-sectional study included 10,796 adults (≥18 years) from the Ningxia Hui Autonomous Region, Northwest China. The HTH/WH phenotype was defined as triglycerides ≥1.7 mmol/L combined with waist-to-height ratio ≥0.5. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for the association between the HTH/WH phenotype and coexisting hypertension, diabetes, and dyslipidemia. Mixed graphical models were employed to characterize the network associations among the HTH/WH phenotype, the three cardiometabolic disorders, and modifiable lifestyle factors.
The prevalence of concurrent hypertension, diabetes, and dyslipidemia was 3.99% in Ningxia, exceeding the Northwest China regional average of 2.33%. The HTH/WH phenotype was present in 21.30% of the population and demonstrated a significant, dose-response association with the triple burden (adjusted OR = 5.29, 95% CI: 4.14-6.74), as well as with two diseases (adjusted OR = 5.12, 95% CI: 4.22-6.21) and one disease (adjusted OR = 1.97, 95% CI: 1.77-2.20). Factors independently associated with the triple burden included age ≥40 years, smoking, alcohol consumption, and elevated BMI (≥24 kg/m²), while higher education and married status were inversely protective. Mixed graphical modeling revealed the HTH/WH phenotype as a central bridge node (bridge strength = 0.67) within the metabolic disorder network, with strong direct connections to hypertension, diabetes, and dyslipidemia. BMI exhibited the highest bridge centrality (bridge strength = 1.72), followed by smoking (bridge strength = 0.32).
In Ningxia Hui Autonomous Region, concurrent hypertension, diabetes, and dyslipidemia pose a substantial health burden among adults. The HTH/WH phenotype may serve as a practical risk assessment indicator for identifying high-risk individuals with this metabolic multimorbidity.

PMID:
42908745
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

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