Prediction of incident hypertension and arterial stiffness using the non–insulin‐based metabolic score for insulin resistance (METS‐IR) index

Abstract

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.

Usefulness of metabolic score for insulin resistance index in estimating the risk of mildly reduced estimate glomerular filtration rate: a cross-sectional study of rural population in China

“…16 Some research also believed MetS-IR could effectively identify the early hypertensive population, 17 especially for patients with dyslipidaemia. 18 Compared with HEC method, MetS-IR was more effective in predicting the risk of type 2 diabetes 19 and ischaemic heart disease. 20 Taken together, increasing evidence suggested that it was suitable for these novel indicators to replace the traditional insulin indexes to evaluate the IR level.…”

Association of metabolic score for insulin resistance and its 6‐year change with incident type 2 diabetes mellitus

“…Metabolic score for insulin resistance (METS-IR), considering FPG, lipid profile, and adiposity index, has been used as a novel inexpensive and reliable surrogate indicator of IR. 10,11 Other surrogate indicators of IR, such as triglycerides (TG)-glucose index (TyG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C), have been used; both were positively associated with incident T2DM. [12][13][14][15] A previous study demonstrated that METS-IR has higher predictive value than TyG and TG/HDL-C ratio.…”

Effects of vitamin K2 supplementation on atherogenic status of individuals with type 2 diabetes: a randomized controlled trial

“…The indexes can be easily determined by routine measurements of FPG, triglycerides, and other lipoproteins. The indexes' associations with subclinical atherosclerosis measurements of coronary artery calcification, arterial stiffness, and vascular flow limitations have been well indicated [5][6][7][8][9]28]. The beneficial effects of an intervention on CVD risk by improving the metabolic variables of glucose and lipids can be exerted earlier by determining the indexes rather than atherosclerosis's clinical measurements.…”

“…These non-insulin based indexes of IR can be easily determined by combinations of traditional risk factors of CVD, including fasting plasma glucose (FPG), lipid profiles, and body mass index (BMI). These indexes were associated with carotid atherosclerosis, vascular calcification, risk of CVD, and clinical outcomes, and therefore suggested to be useful for early detection of subclinical atherosclerosis [5][6][7][8]. The indexes are proposed to predict CVD events stronger than the routine individual lipid measurements [9].…”