Predictive values of metabolic score for insulin resistance on risk of major adverse cardiovascular events and comparison with other insulin resistance indices among Chinese with and without diabetes mellitus: Results from the 4C cohort study

Abstract

Aims/Introduction To investigate the relationship between the metabolic score for insulin resistance (METS‐IR) index and major adverse cardiac events (MACEs) and to compare its ability to predict MACEs with other IR indices including homeostatic model assessment for IR (HOMA‐IR) and triglyceride glucose (TyG) index‐related parameters. Materials and Methods We conducted a cohort study enrolling 7,291 participants aged ≥40 years. Binary logistic regression and restricted cubic splines were performed to determine the association between METS‐IR and MACEs, and the receiver operating curve (ROC) was utilized to compare the predictive abilities of IR indices and to determine the optimal cut‐off points. Results There were 348 (4.8%) cases of MACEs during a median follow‐up of 3.8 years. Compared with participants with a METS‐IR in the lowest quartile, the multivariate‐adjusted RRs and 95% CIs for participants with a METS‐IR in the highest quartile were 1.47 (1.05–2.77) in all participants, 1.42 (1.18–2.54) for individuals without diabetes, and 1.75 (1.11–6.46) for individuals with diabetes. Significant interactions were found between the METS‐IR and the risk of MACEs by sex in all participants and by age and sex in individuals without diabetes (all P values for interaction < 0.05). In the ROC analysis, the METS‐IR had a higher AUC value than other indices for predicting MACEs in individuals with diabetes and had a comparable or higher AUC than other indices for individuals without diabetes. Conclusions The METS‐IR can be an effective clinical indicator for identifying MACEs, as it had superior predictive power when compared with other IR indices in individuals with diabetes.

Negative correlation between metabolic score for insulin resistance index and testosterone in male adults

“…Furthermore, an examination exploring the correlations of the METS-IR, TyG and TG/HDL-C ratio with hypertension revealed solely that the METS-IR is significantly associated with hypertension [ 18 ]. Pan et al conducted a cohort study involving 7291 participants aged 40 or above, demonstrating that METS-IR has a greater predictive capability for major adverse cardiac events compared to other indices such as TyG-BMI, HOMA-IR, TyG-WHtR, TyG, and TyG-WC [ 38 ].…”

Which surrogate insulin resistance indices best predict coronary artery disease? A machine learning approach

“…The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) is a commonly employed alternative, offering ease of use; however, this test cannot be used to diagnose people who are already undergoing insulin treatment [ 12 , 13 ]. Additionally, HOMA-IR has another limitation, as laboratories do not routinely measure circulating insulin concentrations [ 14 , 15 ].…”