The Triglyceride-Glucose Index and Its Combination with C-Reactive Protein and Anthropometric Indicators as Biomarkers for Hypertension Among Saudi Adults: A Cross-Sectional Survey.

Background: Although many inflammatory-metabolic and anthropometric markers are used to diagnose hypertension among adults, there is little research on how these markers can be combined to detect prevalent hypertension in the Saudi population. This study investigated the discriminatory power of an inflammation-based index combining triglyceride and glucose levels (the high-sensitivity C-reactive protein-triglyceride-glucose (hs-CRP-TyG) index), along with anthropometric indicators, to determine hypertension status in a cohort of Saudi adults. Methods: This study used data from a cross-sectional survey conducted in Jeddah (Saudi Arabia) involving 1299 non-diabetic adults, who were grouped based on their blood pressure state into normal BP, prehypertension, and hypertension groups. The anthropometric indicators BMI (body mass index), WC (waist circumference), WC:HT (waist-to-height ratio), WWI (weight-adjusted waist index), and CI (conicity index) were calculated. Multinomial logistic regression was performed to estimate associations between hs-CRP-TyG and hypertension and between hs-CRP-TyG + anthropometric indicators and hypertension. Interaction analyses, sex-stratified analyses, and sensitivity analyses using binomial logistic regression were performed. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminatory accuracy of the hs-CRP-TyG index and its combinations. Results: Baseline characteristics showed significant variations across the blood pressure categories (all p < 0.001). Multinomial logistic regression showed that the hs-CRP-TyG model was significantly associated with hypertension (OR = 1.487, 95% CI: 1.242-1.781; p = 0.001) but not with prehypertension. The WC:HT model was significantly associated with both prehypertension and hypertension and showed comparable discriminatory performance and greater clinical applicability (Nagelkerke R2 = 0.157). Binary logistic regression found that both hs-CRP-TyG (OR = 1.290, p = 0.013) and WC:HT (OR = 1.371, p < 0.001) were significantly associated with hypertension. The combined hs-CRP-TyG + WC:HT model had a numerically higher AUC (0.738) compared to the models with either marker alone in the overall and sex-stratified analyses. Conclusions: The combination of inflammation-based and anthropometric markers showed a numerically higher AUC for discriminating prevalent hypertension compared to the individual markers alone. Although these results suggest the potential utility of combining inflammation-based markers and central obesity markers, external validation is required before this approach can be integrated into clinical practice to assess prevalent hypertension status among Saudi adults.