METS-IR, a novel simple insulin resistance indexes, is associated with hypertension in normal-weight Chinese adults.
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ABSTRACT:
SUBMITTER: Liu XZ
PROVIDER: S-EPMC8030630 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Hypertension is associated with insulin resistance (IR), metabolic syndrome (MS), and arterial stiffness. Non-insulin-based IR indexes were developed as tools for metabolic screening. Here, we aimed to evaluate the novel non-insulin-based Metabolic Score for IR (METS-IR) index for the prediction of incident hypertension and arterial stiffness evaluated using pulse wave velocity (PWV) analysis, compared with other non-insulin-based IR indexes. We evaluated two populations, a cross-sectional evaluation of high-risk individuals (n = 305) with a wide range of metabolic comorbidities and dyslipidemia in whom PWV measurement was performed and a 3-year prospective cohort of normotensive individuals (N = 6850). We observed a positive correlation between METS-IR and PWV in the cross-sectional cohort, which was higher compared with other non-insulin-based fasting IR indexes; furthermore, PWV values >75th percentile were associated with the upper tercile of METS-IR values. In the prospective cohort, we observed an increased risk for incident hypertension for the upper METS-IR tercile (METS-IR ≥ 46.42; HR: 1.81, 95% CI: 1.41-2.34), adjusted for known cardiovascular risk factors, and observed that METS-IR had greater increases in the predictive capacity for hypertension along with SBP and the Framingham Hypertension Risk Prediction Model compared with other non-insulin-based IR indexes. Therefore, METS-IR is a novel non-insulin-based IR index which correlates with arterial stiffness and is a predictor of incident hypertension, complementary to previously validated risk prediction models.
| S-EPMC8030285 | biostudies-literature
Project description:Insulin resistance in obesity coincides with abnormalities in lipid profile and lipoprotein subclass distribution and size even before abnormalities in glucose homeostasis manifest. We aimed to assess this relationship in the absence of obesity. Insulin sensitivity (3-h intravenous glucose tolerance test and minimal modeling) and lipoprotein particle concentrations and sizes (proton nuclear magnetic resonance spectroscopy) were evaluated in 15 insulin-resistant and 15 insulin-sensitive lean Asians of Chinese descent with normal glucose tolerance, matched on age, sex, and body mass index. Despite a ~50% lower insulin sensitivity index (Si) in insulin-resistant than in insulin-sensitive subjects, which was accompanied by significantly greater acute insulin response to glucose (AIRg) and fasting insulin concentration but not different fasting glucose concentration, there were no significant differences between groups in the blood lipid profile (p ? 0.44) or the lipoprotein subclass concentrations (p ? 0.30) and particle sizes (p ? 0.43). We conclude that, contrary to observations in subjects with obesity, insulin resistance is not accompanied by unfavorable changes in the plasma lipid profile and lipoprotein particle concentrations and sizes in lean Asians with normal glucose tolerance. Therefore, insulin resistance at the level of glucose metabolism is mechanistically or temporally dissociated from lipid and lipoprotein metabolism. Trial Registration: clinicaltrials.gov, NCT03264001.
| S-EPMC7952320 | biostudies-literature
Project description:BackgroundChronic kidney disease (CKD) has emerged as a mounting public health issue worldwide; therefore, prompt identification and prevention are imperative in mitigating CKD-associated complications and mortality rate. We aimed to compare the predictive powers of the homeostatic model assessment for insulin resistance (HOMA-IR) and the metabolic score for insulin resistance (METS-IR) for CKD incidence in middle-aged and older adults.MethodsThis study used longitudinal prospective cohort data from the Korean Genome and Epidemiology Study. A total of 10,030 participants, aged 40-69 years, residing in the Ansung or Ansan regions of the Republic of Korea, were recruited between 2001 and 2002 through a two-stage cluster sampling method. We compared the predictive powers of METS-IR and HOMA-IR for CKD prevalence and incidence, respectively. CKD prevalence was measured by the area under the receiver operating characteristic (ROC) curve (AUC), and the indices' predictive performance for CKD incidence were assessed using Harrell's concordance index and time-dependent ROC curve analysis.ResultsA total of 9261 adults aged 40-69 years at baseline and 8243 adults without CKD were included in this study. The AUCs and 95% confidence intervals (CIs) of HOMA-IR and METS-IR for CKD prevalence at baseline were 0.577 (0.537-0.618) and 0.599 (0.560-0.637), respectively, with no significant difference (p = 0.337). The Heagerty's integrated AUC for METS-IR in predicting CKD incidence was 0.772 (95% CI 0.750-0.799), which was significantly higher than that of HOMA-IR (0.767 [95% CI 0.742-0.791], p = 0.015).ConclusionMETS-IR surpassed HOMA-IR in predicting CKD incidence and was as effective as HOMA-IR in predicting CKD prevalence. This implies that METS-IR could be a valuable indicator for early detection and prevention of CKD among Korean adults.
| S-EPMC10644442 | biostudies-literature
Project description:BackgroundInsulin resistance has been reported to increase the risk of breast, prostate and colorectal cancer. However, the role of insulin resistance and its interaction with genetic risk in the development of lung cancer remains controversial. Therefore, we aimed to explore the association between a novel metabolic score for insulin resistance (METS-IR) and lung cancer risk.MethodsA total of 395 304 participants without previous cancer at baseline were included. The Cox proportional hazards regression model was performed to investigate the association between METS-IR and lung cancer risk. In addition, a Mendelian randomization analysis was also performed to explore the causal relationship. The joint effects and additive interactions between METS-IR and polygenetic risk score (PRS) of lung cancer were also investigated.ResultsDuring a median follow-up of 11.03 years (Inter-quartile range (IQR): 10.30-11.73), a total of 3161 incident lung cancer cases were diagnosed in 395 304 participants. There was a significant association between METS-IR and lung cancer risk, with an HR of 1.28 (95% CI: 1.17-1.41). Based on the Mendelian randomization analysis, however, no causal associations were observed. We observed a joint effect but no interaction between METS-IR and genetic risk. The lung cancer incidence was estimated to be 100.42 (95% CI: 91.45-109.38) per 100 000 person-year for participants with a high METS-IR and PRS, while only 42.76 (95% CI: 36.94-48.59) with low METS-IR and PRS.ConclusionsHigh METS-IR was significantly associated with an increased risk of lung cancer. Keeping a low level of METS-IR might help reduce the long-term incident risk of lung cancer.
| S-EPMC11293818 | biostudies-literature
Project description:ObjectivesMetabolic dysfunction-associated fatty liver disease (MAFLD), a globally prevalent disease, is closely linked to insulin resistance (IR). Physical activity (PA) is closely linked to both MAFLD and IR. We aim to explore the dose-response relationship between metabolic score for IR (METS-IR)/homeostasis model assessment of IR (HOMA-IR) and MAFLD, and investigate the relationship between PA, IR and MAFLD.MethodsParticipants from the NHANES study were included in this cross-section study. Logistic regression and the receiver operating characteristic were used to assess the predictive performance of METS-IR/HOMA-IR for MAFLD. Restrictive cubic splines were performed to visualize their dose-response relationship. Decision tree analysis was used to identify high-risk populations of MAFLD. PA's mediating effect in the association between METS-IR/HOMA-IR and MAFLD was also examined.ResultsOf all 1,313 participants, 693 had MAFLD (52.78%). There were a positive association between METS-IR (OR = 1.162, 95% CI = 1.126-1.199) and HOMA-IR (OR = 1.630, 95% CI = 1.431-1.856) and MAFLD risk. The AUCs of the METS-IR and HOMA-IR were 0.831 (0.809, 0.853) and 0.767 (0.741, 0.791), respectively, with significantly different predictive performance (P < 0.001). Adding METS-IR/HOMA-IR to the basic model greatly improved the statistical significance for MAFLD. Five high-risk subgroups were identified for MAFLD. PA mediated about 0.81% and 0.78% (indirect effect/total effect) in the association between METS-IR/HOMA-IR and MAFLD.ConclusionsMAFLD risk might be predicted by METS-IR/HOMA-IR, among which METS-IR performed better. And PA mediated the association between them. More attention should be paid to the therapeutic effect of lifestyle changes on MAFLD.Highlights1. Positive associations were found between METS-IR and HOMA-IR and MAFLD risk. 2. METS-IR has better predictive performance for MAFLD risk than HOMA-IR. 3.Two high-risk subgroups were identified for MAFLD by METS-IR: individuals with METS-IR ≥ 40; Hispanic black individuals with 34 ≤ METS-IR < 40 and aged ≥ 46. 4. In the significant association between METS-IR/HOMA-IR and MAFLD, about 0.81% and 0.78% (indirect effect/total effect), respectively, were mediated by physical activity.
| S-EPMC11293050 | biostudies-literature
Project description:BackgroundThe increase in diabetes worldwide is alarming. Decreased acute insulin response to intravenous glucose tolerance test (IVGTT) during first-phase insulin secretion (FPIS) is a characteristic of diabetes. However, knowledge of the insulin secretion characteristics identified by different time to glucose peak in subjects with different metabolic state is sparse.AimsThis study aimed to find different patterns of FPIS in subjects with normal glucose tolerance (NGT) and analyzed the relationship between insulin secretion patterns and the risk for development of type 2 diabetes mellitus (T2DM).MethodsA total of 126 subjects were divided into three groups during a 10-min IVGTT, including NGT with time to glucose peak after 3 min (G1, n = 21), NGT with time to glucose peak at 3 min (G2, n = 95), and prediabetes or diabetes with time to glucose peak at 3 min (G3, n = 10). Glucose, insulin, and C-peptide concentrations at 0, 3, 5, 7, and 10 min during the IVGTT were tested. IVGTT-based indices were calculated to evaluate the insulin secretion and insulin sensitivity.ResultsAge, body mass index (BMI), waist-to-hip ratio, triglyceride (TG), and hemoglobin A1c (HbA1c) of subjects were gradually higher, while high-density lipoprotein cholesterol (HDL-C) was gradually lower from G1 to G3 (p for linear trend <0.05), and the differences between G1 and G2 were also statistically significant (p < 0.05). Glucose peak of most participants in G1 converged at 5 min, and the curves shape of insulin and C-peptide in G2 were the sharpest among three groups. There was no significant difference in all IVGTT-based indices between G1 and G2, but AUCIns, AUCIns/AUCGlu, and △Ins3/△Glu3 in G2 were the highest, and the p-value for linear trend of those indices among three groups were statistically significant (p < 0.05).ConclusionsTwo patterns of FPIS were in subjects with NGT, while subjects with later time to glucose peak during FPIS might be less likely to develop T2DM in the future.
| S-EPMC8635794 | biostudies-literature
Project description:ObjectiveThe metabolic score for insulin resistance (MetS-IR) is an emerging surrogate marker for insulin resistance (IR). This study aimed to investigate the association and sex differences between MetS-IR and prediabetes risk in a Chinese population.MethodsThis cohort study included 100,309 adults with normoglycemia at baseline and had followed longitudinally for 5 years, and with prediabetes, defined according to the 2018 American Diabetes Association (ADA) recommended diagnostic criteria, as the outcome of interest. Multivariate Cox proportional hazards regression and restricted cubic spline (RCS) regression models were used to assess the association between MetS-IR and prediabetes risk.ResultsDuring an observation period of 312,843 person-years, 7,735 (14.84%) men and 4,617 (9.57%) women with pre-diabetes onset were recorded. After fully adjusting for confounders, we found an independent and positive correlation between MetS-IR and the risk of prediabetes in the Chinese population, and the degree of correlation was stronger in women than in men (HR: 1.24 vs 1.16, P-interaction<0.05). Furthermore, using RCS nested in the Cox regression model, we found that there was a nonlinear correlation between MetS-IR and prediabetes risk in both sexes with an obvious saturation effect point, and when the MetS-IR was greater than the value of the saturation effect point, the risk of prediabetes was gradually leveling off. We further calculated the saturation effect points of MetS-IR used to evaluate the risk of prediabetes which in men was 42.82, and in women was 41.78.ConclusionIn this large cohort study, our results supported that MetS-IR was independently and positively associated with the risk of prediabetes in the Chinese population, with the association being stronger in women than in men.
| S-EPMC10226663 | biostudies-literature
Project description:A considerable chronic disease burden existed in people with normal body mass index (BMI), it is imperative to study the prevailing trends in abdominal obesity among Chinese people with normal BMI. Hence, we aimed to analyze updated prevalence data on abdominal obesity trends among Chinese adults with a normal BMI. We used data from the China Health and Nutrition Survey (CHNS) conducted between 1993 and 2015. Abdominal obesity is defined as waist circumference (WC) ≥ 90 cm for men and ≥ 80 cm for women following the International Diabetes Federation recommendations for Asians. Over the 23-year period, the age-standardized mean WC values showed a significant increasing trend among Chinese adults with BMI < 25 kg/m2, with the mean value increased from 74.0 cm to 78.5 cm (P for trend < 0.0001). During the period of 1993-2015, the age-standardized prevalence of abdominal obesity increased from 12.1 to 26.0% (P for trend < 0.0001). Significant increases were observed in both sexes, all age groups, rural and urban residents, and all educational attainment groups (all P for trends < 0.0001), with a greater relative increase noted among men, younger participants, and rural residents. Similar significant trends were noted when a more stringent BMI < 23 kg/m2 cut point (Asian cut point) was applied. A low magnitude of overlap existed between abdominal obesity and general obesity, irrespective of the criteria used. The mean WC and the prevalence of abdominal obesity among Chinese adults with normal BMI increased continuously from 1993 to 2015. The upward trends were noted in both sexes, all age groups, rural and urban regions, and all educational attainment groups. Our estimates emphasize the importance of adding WC in addition to BMI as measures to monitor obesity prevalence.
| S-EPMC8360975 | biostudies-literature
Project description:Normal weight central obesity (NWCO), a distinct phenotype of obesity that is associated with a higher risk of cardiometabolic dysregulation, has received growing attention in the scientific literature. In this study, we aimed to report the prevalence of NWCO in the general Chinese adults and its secular trend from 1993 to 2011. The comorbid cardiometabolic risk of NWCO was also explored. Data from the China Health and Nutrition Survey (CHNS) 1993-2011 were obtained. NWCO was defined as the combination of a BMI of 18.5-23.9 kg/m2 and 1) a waist circumference (WC) of >85 cm in males or >80 cm in females (NWCO by WC); 2) a waist to height ratio (WHtR) of ≥0.5 (NWCO by WHtR); 3) a waist to hip ratio (WHR) of ≥0.9 in males or ≥0.85 in females (NWCO by WHR). We assessed the trend of NWCO prevalence with the generalized estimating equation method. The demographic, socioeconomic, geographic, behavioural and cardiometabolic predictors of NWCO were explored with multivariable logistic regression. From 1993 to 2011, the age-standardized prevalence of NWCO by WC increased from 6.65% (95% CI: 6.09-7.26) to 13.24% (95% CI: 12.58-13.93), and that of NWCO by WHtR and NWCO by WHR rose from 13.18% (95% CI: 12.41-13.98) to 17.06% (95% CI: 16.35-17.79) and from 16.14% (95% CI: 15.3-17.01) to 19.04% (95% CI: 18.25-19.85) respectively. The associated cardiometabolic factors of NWCO (by WC, WHtR and WHR) were hypertension, diabetes, insulin resistance, decreased insulin sensitivity, low high-density lipoprotein and elevated triglyceride. Moreover, NWCO by WC and NWCO by WHtR were associated with a decreased risk of impaired insulin secretion, and NWCO by WC was additionally linked to elevated total cholesterol. The prevalence of NWCO in the general Chinese adults increased significantly from 1993 to 2011. Effective strategies are needed to combat this epidemic and reduce its deleterious health outcomes.
| S-EPMC6443661 | biostudies-literature
Project description:PurposeThis study aims to compare the association of hypertension plus hyperuricemia (HTN-HUA) with seven anthropometric indexes. These include the atherogenic index of plasma (AIP), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), body roundness index (BRI), a body shape index (ABSI), and the cardiometabolic index (CMI).MethodsData was procured from the National Health and Nutrition Examination Survey (NHANES), which recruited a representative population aged 18 years and above to calculate these seven indexes. Logistic regression analysis was employed to delineate their correlation and to compute the odds ratios (OR). Concurrently, receiver operating characteristic (ROC) curves were utilized to evaluate the predictive power of the seven indexes.ResultsA total of 23,478 subjects were included in the study. Among these, 6,537 (27.84%) were patients with HUA alone, 2,015 (8.58%) had HTN alone, and 2,836 (12.08%) had HTN-HUA. The multivariate logistic regression analysis showed that the AIP, LAP, VAI, TyG, BRI, ABSI, and CMI were all significantly associated with concurrent HTN-HUA. The OR for the highest quartile of the seven indexes for HTN-HUA were as follows: AIP was 4.45 (95% CI 3.82-5.18), LAP was 9.52 (95% CI 7.82-11.59), VAI was 4.53 (95% CI 38.9-5.28), TyG was 4.91 (95% CI 4.15-5.80), BRI was 9.08 (95% CI 7.45-11.07), ABSI was 1.71 (95% CI 1.45 -2.02), and CMI was 6.57 (95% CI 5.56-7.76). Notably, LAP and BRI demonstrated significant discriminatory abilities for HTN-HUA, with area under the curve (AUC) values of 0.72 (95% CI 0.71 - 0.73) and 0.73 (95% CI 0.72 - 0.74) respectively.ConclusionThe AIP, LAP, VAI, TyG, BRI, ABSI, and CMI all show significant correlation with HTN-HUA. Notably, both LAP and BRI demonstrate the capability to differentiate cases of HTN-HUA. Among these, BRI is underscored for its effective, non-invasive nature in predicting HTN-HUA, making it a superior choice for early detection and management strategies.
| S-EPMC10958198 | biostudies-literature