Insulin Resistance Indices and Carotid Intima-media Thickness in Physically Fit Adults: CHIEF Atherosclerosis Study

Yen-Po Lin; Yi-Chiung Hsu; Kun-Zhe Tsai; Younghoon Kwon; Gen-Min Lin

doi:10.2174/1871530323666230324104737

Insulin Resistance Indices and Carotid Intima-media Thickness in Physically Fit Adults: CHIEF Atherosclerosis Study

Endocr Metab Immune Disord Drug Targets. 2023;23(11):1442-1448. doi: 10.2174/1871530323666230324104737.

Authors

Yen-Po Lin^{1

2

3}, Yi-Chiung Hsu^{1

4}, Kun-Zhe Tsai^{5

6}, Younghoon Kwon⁷, Gen-Min Lin^{2

3

8}

Affiliations

¹ Department of Biomedical Sciences & Engineering, National Central University, Taoyuan, Taiwan.
² Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.
³ Department of Critical Care Medicine, Taipei Tzu Chi General Hospital, New Taipei City, Taiwan.
⁴ Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
⁵ Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan.
⁶ Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
⁷ Department of Medicine, University of Washington, Seattle, WA, USA.
⁸ Department of Medicine, Tri-Service General Hospital, and National Defense Medical Center, Taipei, Taiwan.

PMID: 36967464
DOI: 10.2174/1871530323666230324104737

Abstract

Aims: This study aims to examine the associations between various non-insulin-based insulin resistance (nIIR) indices and subclinical atherosclerosis assessed by carotid intima-media thickness (cIMT) in young adults.

Background: nIIR indices, e.g., serum triglycerides (TG) have been reported with an association with cIMT in middle- and old-aged adults.

Objective: We examined the associations of various well-known nIIR indices reported before with cIMT in young adults.

Methods: A total of 1,822 young adults free of diabetes in Taiwan were included in 2018-2020. nIIR indices were assessed by TG concentrations, the TyG index, defined as Ln (TG *fasting glucose/2), the TG/high-density lipoprotein cholesterol (HDL-C) ratio, defined as TG divided by HDL-C, and the metabolic score for IR (METS-IR), defined as Ln[(2*fasting glucose)+TG) * body mass index (BMI)/(Ln(HDL-C))]. Multivariable linear regression analyses with adjustments for age, sex, anthropometrics, smoking, alcohol consumption, blood pressure, and total cholesterol were used to determine the associations. For TG only, HDL-C and fasting glucose were additionally adjusted.

Results: In the overall participants, there was an association between cIMT and TG (β: 0.057, p = 0.04). In subgroup analyses, cIMT was associated with TG (β: 0.127, p = 0.004), the TyG index (β: 0.119, p = 0.01), and TG/HDL-C (β: 0.081, p = 0.03) in the overweight / obese (BMI ≥25 kg/m2), while not in the normal weight individuals. However, cIMT was correlated with TG (β: 0.086, p = 0.01) and TG/HDL-C (β: 0.077, p = 0.01) in those without hyperuricemia, while not in those with hyperuricemia. No association between the METS-IR and cIMT in any young adult subgroups was observed.

Conclusion: This study highlights that some nIIR indices could be used to assess cIMT in young adults, particularly for those with obesity and those without hyperuricemia. The TG-based indices instead of the novel marker, METS-IR, are suggestive as stronger predictors of greater cIMT in young adults.

Keywords: Carotid intima-media thickness; METS-IR; TG/HDL-C ratio; TyG index; insulin resistance; young adults.

MeSH terms

Atherosclerosis* / diagnosis
Atherosclerosis* / epidemiology
Carotid Intima-Media Thickness
Cholesterol, HDL
Glucose
Humans
Hyperuricemia*
Insulin
Insulin Resistance*
Middle Aged
Obesity
Risk Factors
Triglycerides
Young Adult

Substances

Insulin
Triglycerides
Cholesterol, HDL
Glucose