Association of the metabolic score for insulin resistance with cardiovascular diseases, cardiovascular and all-cause mortality in Chinese hypertensive population

Front Endocrinol (Lausanne). 2024 Mar 8:14:1326436. doi: 10.3389/fendo.2023.1326436. eCollection 2023.

Abstract

Importance: Little is known about the relationship between the metabolic score for insulin resistance (METS-IR) and the prognosis of hypertensive patients in China.

Objective: To investigate the association between the novel non-insulin-based METS-IR index and the cardiovascular composite endpoints and all-cause mortality in Chinese hypertensive participants.

Design setting and participants: This cohort study used data from the China H-Type Hypertension Project, a long-term prospective cohort consisting of 14234 hypertensive patients in southern China, with a baseline from March to August 2018. The median follow-up period for participants was 3.94 years, as of 2022. The data analysis period is from July 2023 to September 2023.

Exposures: METS-IR index of participants in the Chinese H-type hypertension project. The calculation formula for METS-IR is (Ln (2 × FPG) +TG) × BMI/Ln (HDL-C).

Main outcomes and measures: Cardiovascular events and cardiovascular, all-cause mortality were identified by linking the cohort database with the health care system through October, 2023.

Results: A total of 14220 participants were included in this study. The prevalence rates of cardiovascular disease (CVD), cardiovascular death, and all-cause death were 2.59% (369/14220), 2.79% (397/14220), and 5.66% (805/14220), respectively. After adjusting for confounding factors in the multivariate logistic regression analysis models, the METS-IR index was significantly positively correlated with CVD, and cardiovascular, all-cause mortality, whether as a categorical or continuous variable. Layered analysis showed that the METS-IR index of hypertensive participants in different subgroups was positively correlated with the endpoint event.

Conclusions and relevance: This large, prospective cohort study demonstrated that the METS-IR index, a new IR evaluation index, were independently associated with a higher risk of the cardiovascular composite endpoint and all-cause mortality among Chinese hypertensive population. Importantly, our finding provides an independent indicator for evaluating the prognosis of hypertensive patients.

Keywords: METS-IR; all-cause mortality; cardiac death; cardiovascular events; insulin resistance; shock.

MeSH terms

  • Cardiovascular Diseases* / etiology
  • Cohort Studies
  • Humans
  • Hypertension* / complications
  • Insulin
  • Insulin Resistance*
  • Metabolic Syndrome* / epidemiology
  • Prospective Studies

Substances

  • Insulin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Cultivation of backup projects for National Science and Technology Awards(20223AEI91007), Jiangxi Science and Technology Innovation Base Plan - Jiangxi Clinical Medical Research Center (20223BCG74012), Science and Technology Innovation Base Construction Project (20221ZDG02010), Jiangxi Provincial Natural Science Foundation (20212ACB206019, 20224BAB206090, 20232BAB206140, 20232ACB216006), Jiangxi Provincial Health Commission Science and Technology Project (202130440, 202210495, 202310528), Jiangxi Provincial Drug Administration Science and Technology Project (2022JS41, 2023JS26), Fund project of the Second Affiliated Hospital of Nanchang University (2016YNQN12034, 2019YNLZ12010, 2021efyA01, 2021YNFY2024).