Association between insulin resistance surrogate indicators and six-month prognosis in patients with...

BackgroundInsulin resistance (IR) may influence the treatment responses of medication-overuse headache (MOH), but evidence is limited. This study explored the relationship of four surrogate IR indices-triglyceride-glucose (TyG) index, triglyceride to HDL-C (TG/HDL-C) ratio, TyG-body mass index (TyG-BMI), and metabolic score for IR (METS-IR)-with six-month treatment responses in MOH patients after withdrawal and preventive therapy.MethodsMOH patients from June 2020 to July 2024 were consecutively enrolled in this retrospective cohort study. Patients were categorized into four groups according to quartiles of each baseline IR index. Six months post-treatment, patients reducing monthly headache days by at least 50% from baseline and stopping acute medication overuse were deemed to achieve a '50% response status'; others were classified as a 'non-50% response status'. Logistic regression analyses were utilized to assess the relationship of the IR indices with 50% response status.ResultsIn the final analysis of 201 enrolled MOH patients (71.6% female) out of an initial 264, 109 (54.2%) achieved a 50% response status at the six-month follow-up. In unadjusted analysis, the TyG index (continuous: OR 1.72, 95% CI 0.97-3.06, P = 0.064; highest vs. lowest quartile: OR 2.16, 95% CI 0.97-4.81, P = 0.058) showed no significant association with 50% response status. After adjustment, both the continuous TyG index (OR 2.25, 95% CI 1.07-4.70, P = 0.032) and the highest quartile (OR 2.95, 95% CI 1.09-8.00, P = 0.033) became significantly associated with the outcome. In contrast, the TG/HDL-C ratio, METS-IR, and TyG-BMI index did not reach significance in the final adjusted model.ConclusionsThe TyG index was associated with 50% response status in MOH patients, warranting further validation.