The Body mass index-glucose Index as a New Tool for Early Detection of the Risk of Dysglycemia in Patients with Hypertension and Obstructive Sleep Apnea

Purpose: Currently, there is a lack of early biomarkers to identify the risk of dysglycemia in patients with concurrent hypertension and obstructive sleep apnea (OSA). The aim of our study is to evaluate the efficacy of the recently proposed Body Mass Index (BMI)-Glucose (ByG) index in identifying the risk of dysglycemia in patients with hypertension and OSA. Methods: A retrospective cohort study of 1579 adults with hypertension and OSA from the Urumqi Research on Sleep Apnea and Hypertension study (UROSAH) was conducted. Cox proportional hazards models were used to assess the associations between the ByG index and new-onset dysglycemia, diabetes, and prediabetes. Time-dependent receiver operating characteristic (ROC) curves to compare the efficacy of the ByG index with traditional insulin resistance indicators. Results: During a median follow-up of 7.25 years, 212 cases of dysglycemia (157 diabetes, 55 prediabetes) were identified. Participants in the highest ByG tertile had a significantly increased risk of dysglycemia (HR 3.07; 95% CI: 2.03–4.67), diabetes (HR 3.34; 95% CI: 2.01–5.57), and prediabetes (HR 2.60; 95% CI: 1.24–5.43) compared to the lowest tertile, after full adjustment. Time-dependent ROC showed the ByG index was more discriminative in predicting dysglycemia (including diabetes and prediabetes) events at 3, 5 and 7 years compared to BMI, TyG and TyG-BMI indices. Conclusion: The ByG index demonstrates a significant association with the risk of new-onset dysglycemia, encompassing both diabetes and prediabetes, in patients with hypertension and OSA. This straightforward tool can facilitate the early identification of high-risk individuals and provide individualized dysglycemia prevention. Trial registration : Not applicable.