Association of METS-IR with incident hypertension in non-overweight adults based on a cohort study in Northeastern China

Abstract

Background Insulin resistance (IR) plays an important role in the progression of hypertension (HTN); therefore, early identification of IR is clinically important for preventing HTN. Our study aims to explore the relationship between the metabolic score for IR (METS-IR) and HTN in Chinese population who maintained non-overweight. Methods A total of 4678 adults who underwent annual health check-up in our institution from 2010 to 2017, did not have HTN at the first check-up and maintained non-overweight at follow-up were selected as subjects. The baseline METS-IR was calculated and the outcome was incident HTN. Cox proportional hazards regression models were used to evaluate hazards ratios of HTN for METS-IR. Additionally, sensitive analyses and stratification analyses were used to deeply verify the relationship of METS-IR with HTN. The dose–response association between METS-IR and HTN risk was investigated using restricted the cubic spline analysis fitted for the Cox proportional hazards model. Results Compared with the first quartiles of METS-IR, the risk of incident HTN was increased by 58% [hazard ratio (HR) 1.58, 95% confidence interval (CI) 1.12–2.22] and 96% (HR 1.96, 95% CI 1.40–2.76) in the Q3 group and the Q4 group, respectively. The results remained consistent when analyses were restricted to people without abnormal high-density lipoprotein cholesterol, triglyceride or fasting plasma glucose level at baseline. A linear dose–response relationship between METS-IR and HTN risk was identified (HR 1.08, 95% CI 1.04–1.12). Conclusions The risk of incident HTN was associated with elevated METS-IR levels in non-overweight individuals. METS-IR could help predict the risk of HTN in non-overweight individuals.

Association Between the Metabolic Score for Insulin Resistance and Hypertension in Adults: A Meta-Analysis

“…4b, p for subgroup difference all > 0.05). Results of meta-analysis with METS-IR analyzed in continuous variables also showed that METS-IR was associated with the risk of hypertension (four datasets [26][27][28], RR for 1-unit increment of METS-IR: 1.15, 95 % CI: 1.08 to 1.23, p < 0.001, I 2 = 79 %; ▶ Fig. 5).…”

“…As shown in Table 1 , eight observational studies, including two cohort studies 21 28 and six cross-sectional studies 22 23 24 25 26 27 , were included in the meta-analysis. These studies were published between 2019 and 2022, and performed in Mexico 21 , China 22 23 24 25 , 27 28 , and Japan 26 .…”

“…As shown in Table 1 , eight observational studies, including two cohort studies 21 28 and six cross-sectional studies 22 23 24 25 26 27 , were included in the meta-analysis. These studies were published between 2019 and 2022, and performed in Mexico 21 , China 22 23 24 25 , 27 28 , and Japan 26 . Four of them included community-derived adult population 21 23 , 26 27 , and the other four included adults for routine health check 22 24 , 25 28 .…”

“…These studies were published between 2019 and 2022, and performed in Mexico 21 , China 22 23 24 25 , 27 28 , and Japan 26 . Four of them included community-derived adult population 21 23 , 26 27 , and the other four included adults for routine health check 22 24 , 25 28 . Overall, 305 341 adults were included in the meta-analysis, and 47 887 (15.7%) of them had hypertension.…”

“…Then, an additional 147 articles were excluded since the contents of the titles and abstracts indicated that they were not relevant to the aim of the meta-analysis, which made a total of 18 studies for the full-text review. Finally, after excluding ten studies through full-text review, eight studies [21][22][23][24][25][26][27][28] were included. The reasons for the removing of the ten studies are also presented in ▶Fig.…”