Propensity score analysis of triglyceride-glucose index in newly diagnosed patients with essential hypertension as a predictor of microalbuminuria

Background The Triglyceride-Glucose (TyG) index has emerged as a potential predictor for microalbuminuria (MAU) in patients with essential hypertension. This study aims to assess the TyG index as a predictor of MAU in newly diagnosed hypertensive patients, using propensity score matching (PSM) to control for confounding factors. Methods A cohort of 2,052 newly diagnosed hypertensive patients from Changde Hospital, China (January 2020 to December 2024), was analyzed. The TyG index cutoff value was determined by receiver operating characteristic (ROC) analysis, with a value of 9.125. PSM was employed to balance baseline differences between low and high TyG index groups, and logistic regression models were used to analyze the association between TyG index and MAU. Subgroup analyses and sensitivity analyses were conducted to evaluate the robustness of the findings. Results In the final cohort, 2,052 patients were divided into two groups based on the optimal TyG index cutoff value of 9.125. After propensity score matching (PSM), the high TyG index group (≥9.125) exhibited significantly higher rates of MAU compared to the low TyG index group (9.125). In the adjusted models, the odds ratio (OR) for MAU in the high TyG index group was 2.37 (95% CI 1.73–3.26). The analysis revealed a non-linear, L-shaped association between TyG index and MAU, with a marked increase in the prevalence of MAU in the high TyG group. Sensitivity analyses, including inverse probability treatment weighting (IPTW), reinforced these findings, with the high TyG index group consistently showing a higher risk of MAU across both original and matched cohorts. Conclusions The TyG index is a simple and accessible biomarker for predicting MAU in newly diagnosed hypertensive patients, providing valuable insight for early detection of kidney damage in this population.