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Research Article: Association between triglyceride-glucose body mass index and risk of hypertensive disorders of pregnancy: a case-control study

Date Published: 2026-06-25

Abstract:
To investigate the association between triglyceride-glucose body mass index (TyG-BMI) and the risk of hypertensive disorders of pregnancy (HDP), and to compare the discriminative ability of TyG-BMI with triglyceride-glucose index (TyG) and body mass index (BMI) for HDP. A case-control study was conducted including 346 pregnant women hospitalized in the Department of Obstetrics at Fuyang Women and Children's Hospital from January 2021 to December 2025. Participants were divided into HDP group ( n = 168) and control group ( n = 178) based on HDP diagnosis. General clinical data, physical examinations, and hematological parameters at admission were collected for both groups. BMI, TyG index, and TyG-BMI were calculated. Multivariable logistic regression was used to analyze the independent association between TyG-BMI and HDP. Restricted cubic spline (RCS) curves were employed to explore dose-response relationships. Receiver operating characteristic (ROC) curves were used to compare the discriminative performance of different indices. The TyG-BMI level in the HDP group was significantly higher than that in the control group (228.4 ± 44.6 vs. 196.8 ± 36.2, P < 0.001). Multivariable logistic regression analysis showed that after adjusting for confounding factors, each 10-unit increase in TyG-BMI was associated with a 30% increase in HDP risk (adjusted OR = 1.30, 95%CI: 1.16–1.46, P < 0.001). RCS analysis demonstrated a non-linear positive association between TyG-BMI and HDP risk ( P for non-linearity = 0.026). ROC analysis revealed that the area under the curve (AUC) for TyG-BMI in discriminating HDP was 0.782 (95%CI: 0.734–0.830), which was significantly superior to TyG index (AUC = 0.708, P = 0.005) and BMI (AUC = 0.694, P < 0.001). Subgroup analysis showed that the association between TyG-BMI and HDP remained consistent across all subgroups (all P for interaction > 0.05). TyG-BMI is independently and positively associated with HDP, and its discriminative performance is superior to TyG index and BMI. It can serve as a comprehensive indicator for identifying and assessing the degree of metabolic abnormalities in HDP patients.

Introduction:
HDP represent serious pregnancy-specific complications encompassing various clinical types including gestational hypertension, preeclampsia, eclampsia, and chronic hypertension with superimposed preeclampsia. The global incidence ranges from 5% to 10%, reaching 10% to 15% in developing countries ( 1 ). A multicenter cross-sectional study based on hospital data in China reported that the incidence of HDP among hospitalized pregnant women ranged from 5.6% to 9.4%, with an increasing trend in recent years ( 2 ). HDP…

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