Predictive value of ultrasound assessment of carotid IMT and elastic parameters combined with blood TyG for disease progression in young and middle-aged people with high-normal blood pressure

ZHENG Yingjuan; HU Minxia; LIU Wei

doi:10.3969/j.issn.1002-3429.2025.21.008

Abstract：Objective To study the predictive value of ultrasound assessment of carotid intima-media thickness(IMT)and elastic parameters combined with blood triglyceride-glucose index(TyG)on disease progression in young and middle-aged people with high-normal blood pressure(BP).Methods A prospective study was conducted on 145 middle-aged and young patients with high-normal BP(high-normal BP group)and 155 patients with hypertension(hypertension group)admitted to our hospital from June 2021 to November 2024,and 148 healthy individuals who underwent physical examination during the same period were selected as the control group.Baseline data,IMT,elastic parameters[compliance coefficient(CC)of common carotid artery,dilation coefficient(DC),stiffness coefficient(α,β)]of each group were compared.The impact of changes in TyG,IMT,and elasticity parameters on the disease progression in young and middle-aged individuals with high-normal BP was analyzed using multivariate logistic regression.Smooth curve fitting analysis was performed to assess the correlation between TyG,IMT,elastic parameters and the disease progression in young and middle-aged populations with high-normal BP.The receiver operating characteristic(ROC)curve was used to analyze the value of different schemes in predicting disease progression.Results LDL-C,TG,TC,and TyG in the hypertension group and the high-normal BP group were higher than those in the control group,which were higher in the hypertension group than in high-normal BP group(P<0.05).The IMT,α,and β in the hypertension group and the high-normal BP group were higher than those in the control group,while the CC and DC were lower than those in the control group(P<0.05).The IMT,α,and β in the hypertension group were higher than those in the high-normal BP group,while the CC was lower than that in the high-normal BP group(P<0.05).Multivariate logistic regression analysis showed that after adjusting for LDL-C,TG,and TC,TyG,IMT,CC,α,and β were still influencing factors for the disease progression in young and middle-aged people with high-normal BP(P<0.05).Smooth curve fitting showed that TyG,IMT,α,and β had a positive linear relationship with the disease progression in middle-aged and young people with high-normal BP,while CC had a negative linear relationship with the disease progression in middle-aged and young people with high-normal BP(P<0.05).The area under the ROC curve(AUC)of traditional+novel types for predicting the disease progression was significantly higher than that of TyG,IMT,CC,α,and β(Z=5.991,4.453,4.080,4.847,4.649,all P<0.001),with the highest predictive value.Conclusion The changes of carotid IMT and elastic parameters in young and middle-aged people with high-normal BP in Hebei Province are closely related to the disease progression.QIMT and QAS ultrasound techniques can sensitively capture the above abnormal changes allowing for personalized prediction of individual disease progression risk.When combined with blood TyG,it can further improve the predictive value and provide a more reliable reference for clinical prevention and treatment of hypertension.