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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
The Metabolic Score for Insulin Resistance (METS-IR) Predicts Cardiovascular Disease and Its Subtypes in Patients
Wenbo Yang1, Xintian Cai1,2, Junli Hu1
1Hypertension Center, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Medical Research Center for Hypertension Diseases, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, People's Republic of China.
Insights
The metabolic score for insulin resistance (METS-IR) effectively predicts cardiovascular disease (CVD) and its subtypes in patients with hypertension and obstructive sleep apnea (OSA), aiding in early risk identification.
Area of Science:
- Cardiology
- Endocrinology
- Sleep Medicine
Background:
- Hypertension and obstructive sleep apnea (OSA) are significant risk factors for cardiovascular disease (CVD).
- Accurate prediction of CVD risk in patients with both conditions is crucial for effective prevention strategies.
Purpose of the Study:
- To evaluate the efficacy of the metabolic score for insulin resistance (METS-IR) index in predicting incident CVD and its subtypes (coronary artery disease and stroke) among individuals with hypertension and OSA.
Main Methods:
- A retrospective cohort study involving 2031 adults with hypertension and OSA from the Urumqi Research on Sleep Apnea and Hypertension (UROSAH) study.
- Multivariate Cox proportional hazards regression models were employed to estimate hazard ratios and 95% credibility intervals for CVD events.
Main Results:
- Over a median follow-up of 6.80 years, 317 participants developed new-onset CVD. Each standard deviation increase in METS-IR was associated with a 30% increased risk of overall CVD, 32% for coronary heart disease (CHD), and 27% for stroke.
- The highest tertile of METS-IR showed significantly greater hazards for CVD (HR 2.05), CHD (HR 1.96), and stroke (HR 2.24) compared to the lowest tertile.
- Incorporating METS-IR improved the prediction accuracy of CVD, CHD, and stroke compared to baseline models.
Conclusions:
- The METS-IR index serves as a potent predictor of cardiovascular disease and its subtypes in patients co-diagnosed with hypertension and OSA.
- METS-IR can enhance the identification of high-risk individuals, facilitating personalized CVD prevention strategies.
Objective:
We aimed to evaluate the METS-IR (metabolic score for insulin resistance) index for the prediction of incident cardiovascular disease (CVD) and its subtypes (coronary artery disease and stroke) in patients with hypertension and obstructive sleep apnea (OSA).
Methods:
A retrospective cohort study was conducted with 2031 adults with hypertension and OSA, participants from the Urumqi Research on Sleep Apnea and Hypertension study (UROSAH). The hazard ratios and 95% CIs (credibility interval) for CVD and its subtypes were estimated using multivariate Cox proportional hazards regression models.
Results:
After a median follow-up of 6.80 years (interquartile range: 5.90-8.00 years), a total of 317 (15.61%) participants developed new-onset CVD, including 198 (9.75%) incident coronary heart disease (CHD) and 119 (5.86%) incident stroke. After adjusting for as many relevant confounding factors as possible, each SD increase in METS-IR was associated with a 30% increased risk of new onset overall CVD events, a 32% increased risk of new onset CHD, and a 27% increased risk of new onset stroke. When METS-IR was assessed as tertiles, after adjustment for fully confounding factors, the highest tertiles versus the lowest tertiles were associated with a greater hazard of CVD (HR 2.05; 95% CI 1.52,-2.77), CHD (HR 1.96; 95% CI 1.35-2.84), and stroke (HR 2.24; 95% CI 1.35-3.72). The results of various subgroups and sensitivity analyses were similar. When METS-IR was added, CVD predictions were reclassified and identified more accurately than baseline models for the C-index, continuous net reclassification improvement, and integrated discrimination index. CHD and stroke showed similar results.
Conclusion:
METS-IR is a powerful predictor of CVD and its subtypes in patients with hypertension and OSA, which can facilitate the identification of high-risk individuals and provide individualized CVD prevention.
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