Mets-IR as a predictor of cardiovascular events in the middle-aged and elderly population and mediator role of blood lipids

Frontiers in Endocrinology

Endocrinology

Guoliang Zou¹  Pengyu Shen²  Taoming Qian³  Yuting Fang³  Xiaomeng Sheng³  Yao Deng³ 

[1] Cardiovascular Disease Branch One, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China;Department of Oncology, Second Ward, The First People’s Hospital of Bei’an City, Harbin, Heilongjiang, China;Graduate School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China;

关键词: CHARLS;    METS-IR;    cardiovascular disease;    stroke;    heart disease;   

DOI  :  10.3389/fendo.2023.1224967

 received in 2023-05-18, accepted in 2023-06-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundCardiovascular disease (CVD) is a global health concern, with a significant impact on morbidity and mortality rates. Using fasting glucose, fasting triglycerides, body mass index (BMI), and high-density lipoprotein cholesterol (HDL-C), the metabolic score of insulin resistance (Mets-IR), a novel index created by Mexican researchers to assess insulin sensitivity, is a more precise way to measure insulin sensitivity. This study aimes to explore the association between Mets-IR and CVD, as well as investigate the potential mediating role of of low-density lipoprotein cholesterol (LDL-C).MethodsThe study’s data came from the 2011 and 2018 China Health and Retirement Longitudinal Studies (CHARLS). We used three logistic regression models to account for the potential effects of ten factors on cardiovascular disease/stroke/heart disease. Moreover, We performed mediation analyses to evaluate the role of LDL-C in the association between Mets-IR and incident CVD.ResultsThis study comprised 4,540 participants, of whom 494 (10.88%) were found to develop disease (CVD). Each interquartile range (IQR) increased in Mets-IR raised the risk of developing CVD by 38% (OR=1.38; 95% CI, 1.21-1.56) and there was a linear dose-response relationship between Mets-IR and the risk of new-onset cardiovascular disease, stroke, and heart disease (Poverall<0.05, Pnon-linear>0.05). Approximately 5% (indirect effect/total effect) of the significant association of Mets-IR with stroke was mediated by LDL-C, respectively. With the addition of Mets-IR to the base model, the continuous net reclassification improvement and integrated discrimination improvement for predicting cardiovascular disease increased by 0.175 (P <0.001) and 0.006 (P <0.001), respectively.Conclusionets-IR is associated with an increased risk of cardiovascular disease/stroke/cardiac issues, with LDL-C mediating these relationships. Improving insulin sensitivity and lipid regulation may be essential and effective preventive measures for cardiovascular events.

【 授权许可】

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Copyright © 2023 Qian, Sheng, Shen, Fang, Deng and Zou