Association between Insulin Resistance and Pan-Immune-Inflammation Value (PIV): results from the National Health and Nutrition Examination Survey (NHANES) 2017–2020

Abstract

Background: Insulin resistance (IR), a hallmark feature of diabetes and metabolic syndrome, is characterized by chronic low-grade inflammation. Pan-immune-inflammation value (PIV), an emerging immune cell count-based inflammatory index, is the global quantifier of the cellular compartment of systemic inflammation. This study determines the association of PIV with various markers of IR. Methods: This retrospective, cross-sectional study was done using the data obtained from the Center for Disease Control-National Health and Nutritional Examination Survey (CDC-NHANES) pre-pandemic data from 2017–2020. Data from 4620 survey participants was included after screening. Homeostasis model assessments of insulin resistance (HOMA-IR) and beta-cell function (HOMA-B), triglyceride glucose (TyG) index, visceral adiposity index (VAI), and lipid accumulation product (LAP) were used as markers of IR. The receiver operating characteristic (ROC) curve and multiple logistic regression are carried out to determine the association between PIV and IR. Results: PIV levels were significantly higher in obesity, diabetes, and metabolic syndrome. HOMA-IR, HOMA-B, LAP, VAI, and TyG were significantly different across PIV quartiles. PIV showed a significant positive association with IR (based on the HOMA-IR cut-off). However, the AUC of ROC for PIV is 0.58, suggesting it may not be useful as a marker to predict IR. Conclusion: In our study, PIV had a significant positive association with IR. However, the ability of PIV to predict IR is not optimal. Hence, large-scale prospective studies are needed to ascertain the role of PIV as a marker for IR.