Abstract
The metabolic score for insulin resistance (METS-IR) is a novel noninsulin-based marker for assessing the risk of insulin resistance and cardiometabolic risk. However, whether METS-IR is associated with incident ischemic heart disease (IHD) risk is not well known. Therefore, we aimed to investigate the longitudinal effect of METS-IR on incident IHD risk in a large cohort of Korean adults without diabetes. Data were assessed from 17,943 participants without diabetes from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to METS-IR index quartiles: (ln ((2 × fasting plasma glucose) + triglyceride) × body mass index)/(ln (HDL-cholesterol)). We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazard regression models over a 50-month period. During the follow-up period, 332 participants (1.9%) developed IHD. HRs of IHD for METS-IR quartiles 1–4 were 1.00, were 1.62 (95% CI 1.04–2.53), 1.87 (95% CI 1.20–2.91), and 2.11 (95% CI 1.35–3.30), respectively, after adjusting for potential confounding variables. A higher METS-IR precedes future IHD among Koreans without diabetes. Moreover, compared with metabolic syndrome, METS-IR had a better predictive value for IHD.
Highlights
Cardiovascular diseases (CVDs) are the leading cause of death worldwide in 2019, and the majority of deaths from CVD are caused by ischemic heart disease (IHD), with most deaths occurring between the ages of 30 and 70 [1,2]
We prospectively investigated the association between metabolic score for insulin resistance (METS-IR) and IHD incidence in a large-scale, community-dwelling Korean population without diabetes using the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment Service (HIRA) database
Mean Body mass index (BMI), mean arterial pressure, total cholesterol, and high-sensitivity C-reactive protein values were highest, and mean high-density lipoprotein cholesterol (HDL-C) levels and estimated glomerular filtration rate (eGFR) were lowest in the highest METS-IR index quartile group
Summary
Cardiovascular diseases (CVDs) are the leading cause of death worldwide in 2019, and the majority of deaths from CVD are caused by ischemic heart disease (IHD), with most deaths occurring between the ages of 30 and 70 [1,2]. IHD is a major cause of rising medical expenses, and the early onset of IHD in the aging population is important because it is one of the factors that lowers the quality of life and increases the burden of social medical expenses [3]. Previous studies have suggested that insulin resistance is significantly related to the development and progression of coronary atherosclerosis and adverse plaque characteristics and is a major risk factor for cardiovascular diseases via pathophysiological mechanisms [4]. Early detection of insulin resistance in the early stages of IHD is
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