Relationship of METS-IR with cardiometabolic multimorbidity in China: a nationwide longitudinal cohort study
Chunyan Zhou1, Yanyu Zhang2, Xiaoyi Liu1
1Department of Geriatrics, Panzhihua Central Hospital, Panzhihua, China.
Insights
The metabolic score for insulin resistance (METS-IR) is strongly linked to a higher risk of developing cardiometabolic multimorbidity (CMM). Higher METS-IR scores predict increased CMM incidence, highlighting its potential as a predictive marker.
Area of Science:
- Cardiology
- Metabolic Health
- Public Health
Background:
- Cardiometabolic multimorbidity (CMM) presents a significant global health challenge due to its high mortality rate.
- Understanding predictive markers for CMM is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the association between the metabolic score for insulin resistance (METS-IR) and the incidence of CMM.
- To evaluate METS-IR as a potential predictor for cardiometabolic multimorbidity.
Main Methods:
- Utilized data from 6,977 individuals in the China Health and Retirement Longitudinal Study (CHARLS) database.
- Employed multiple Cox proportional hazards regression and restricted cubic splines (RCS) analysis to assess the METS-IR and CMM relationship.
- Conducted subgroup analyses and interaction tests to confirm the robustness of the findings.
Main Results:
- Over a median follow-up of 109 months, 745 participants (10.7%) developed new-onset CMM.
- Incidences of CMM increased progressively across METS-IR quartiles, from 4.99% in Q1 to 19.54% in Q4.
- A higher METS-IR was significantly associated with an increased risk of CMM (HRs for Q2-4 vs. Q1: 1.52, 2.02, 3.61).
- RCS analysis confirmed a significant nonlinear association between METS-IR and CMM incidence.
- METS-IR demonstrated a predictive ability of 0.669 for CMM, outperforming other common indices.
Conclusions:
- Elevated METS-IR is closely associated with an increased risk of developing CMM.
- METS-IR shows promise as a valuable tool for predicting and potentially preventing CMM.
- Further research into METS-IR could inform clinical practice for CMM management.
Background:
Cardiometabolic multimorbidity (CMM) has emerged as a global health challenge with a high mortality risk. This study aimed to explore the association between the metabolic score for insulin resistance (METS-IR) and the incidence of CMM.
Methods:
This study included 6,977 individuals in the CHARLS database. We used multiple cox proportional hazards regression and restricted cubic splines (RCS) analysis to evaluate the association between METS-IR and CMM. Subgroup analyses and interaction tests were also performed.
Results:
During a median 109 (108-109) months of follow-up, 745 (10.7%) participants were diagnosed with new-onset CMM. The incidences of CMM among participants in quartiles (Q) 1-4 of METS-IR were 4.99, 7.51, 10.67, and 19.54%, respectively. METS-IR was significantly higher in individuals with CMM compared to those without CMM (p < 0.001). After multivariate adjustment, a higher METS-IR was significantly associated with an increased risk of CMM. Compared to participants in Q1 of METS-IR, the hazard ratios (HRs) (95% confidence intervals [CIs]) using cox proportional hazards regression analysis for those in Q2-4 were 1.52 (1.15-2.00), 2.02 (1.56-2.63), and 3.61 (2.80-4.64), respectively. RCS analysis revealed a significant nonlinear association between METS-IR and CMM (nonlinear p < 0.05). The association between METS-IR and the incidence of CMM was present in almost all the subgroups. Furthermore, the predictive ability of METS-IR for CMM was 0.669, which surpassed that of both the triglyceride to high-density lipoprotein cholesterol ratio and the triglyceride glucose index.
Conclusion:
A higher METS-IR was closely associated with an increased risk of CMM. Further studies on METS-IR could be beneficial for preventing and treating CMM.
