Hypertriglyceridemic Waist Phenotype and Cardiometabolic Risk

The hypertriglyceridemic waist (HTGW) phenotype combines an enlarged waist circumference with elevated circulating triglyceride levels to identify individuals at heightened cardiometabolic risk. This simple, low-cost marker reflects excess visceral adiposity and dysregulated lipid metabolism, both of which drive insulin resistance, systemic inflammation and endothelial dysfunction. Across diverse populations, HTGW has been linked to an increased incidence of type 2 diabetes, prediabetes, hypertension, atherosclerotic cardiovascular disease and metabolic syndrome components. Its appeal lies in its ease of measurement and ability to stratify risk beyond body mass index alone. By flagging those with adverse fat distribution and lipid profiles, the HTGW phenotype serves as a practical tool for early intervention, guiding lifestyle modification and targeted prevention strategies at both clinical and public health levels.

Research from Nature Portfolio

Recent studies have examined the longitudinal impact of HTGW on type 2 diabetes risk in large rural cohorts, demonstrating that individuals with persistent HTGW face a more than sevenfold increased hazard of developing diabetes compared with those with normal waist and triglyceride levels, and that reversion of either component substantially reduces risk. Complementary work has integrated waist circumference with the triglyceride-glucose index to mirror metabolic syndrome features, showing that combined anthropometric-biochemical indices achieve robust performance (area under the ROC curve around 0.81) in diagnosing metabolic syndrome and its components, and proposing threshold values that optimise sensitivity and specificity for clinical screening.

Hypertriglyceridemic Waist Phenotype and Cardiometabolic Risk publication trend

The graph below shows the total number of articles in hypertriglyceridemic waist phenotype and cardiometabolic risk across all publications each year (not limited to Nature Index journals).

Technical terms

Hypertriglyceridemic waist phenotype (HTGW): The concurrent presence of an elevated waist circumference and high fasting triglyceride concentration, used to signal visceral adiposity and lipid dysregulation.

Waist circumference (WC): A measure of abdominal girth, indicative of central fat accumulation and correlated with cardiometabolic risk.

Triglycerides (TG): The main form of circulating fats, elevated levels of which reflect impaired lipid handling and contribute to atherosclerosis.

Metabolic syndrome (MetS): A cluster of interrelated risk factors—central obesity, dyslipidaemia, hypertension and hyperglycaemia—that increase the likelihood of diabetes and cardiovascular disease.

Insulin resistance (IR): A state in which tissues fail to respond adequately to insulin, leading to compensatory hyperinsulinaemia and elevated blood glucose.

References

1. Hypertriglyceridemia-waist and risk of developing type 2 diabetes: The Rural Chinese Cohort Study. Scientific Reports (2017).
2. The hypertriglyceridemic-waist phenotype as a valuable and integrative mirror of metabolic syndrome traits. Scientific Reports (2021).
3. The relationship between hypertriglyceridemic wait-to-height ratio and hypertension–diabetes comorbidity among older adult. Frontiers in Public Health (2023).
4. Association between hypertriglyceridemic-waist phenotype and cardiovascular disease: A cohort study and meta-analysis. Frontiers in Cardiovascular Medicine (2022).
5. Hypertriglyceridemic Waist Phenotype and Its Association with Metabolic Syndrome Components, among Greek Children with Excess Body Weight. Metabolites (2023).