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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1479980

The association between the metabolic score for insulin resistance and mortality in patients with cardiovascular disease: a national cohort study

Provisionally accepted
Xiaozhou Su Xiaozhou Su 1*Huiqing Rao Huiqing Rao 2Chunli Zhao Chunli Zhao 1Donghua Li Donghua Li 1Xianwei Zhang Xianwei Zhang 1
  • 1 Department of Cardiology, Minzu Affiliated Hospital of Guangxi Medical University, Nanning, China
  • 2 Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Region, China

The final, formatted version of the article will be published soon.

    Background The metabolic score for insulin resistance (METS-IR) is a novel index for evaluating insulin resistance and identifying high-risk cardiovascular disease (CVD) patients. This study aims to assess the prognostic value of METS-IR in predicting mortality risk in CVD patients. Methods We analyzed data from 2,515 CVD patients in the National Health and Nutrition Examination Survey (NHANES). Associations between METS-IR and all-cause mortality and cardiovascular mortality were evaluated using multivariable Cox proportional hazards models and restricted cubic splines (RCS). Threshold effects and sensitivity analyses were conducted to ensure robustness. Results Over a median follow-up of 91.4 months, 1,090 patients died, including 447 from cardiovascular causes. A U-shaped relationship was identified between lnMETS-IR and all-cause and cardiovascular mortality, with thresholds at 3.70 and 3.67. Below thresholds, an increase of lnMETS-IR was associated with a 75% reduction in the risk of all-cause mortality (HR: 0.25, 95% CI: 0.14–0.46) and a 79% reduction in the risk of cardiovascular mortality (HR: 0.21, 95% CI: 0.07–0.56). While above thresholds, an increase of lnMETS-IR was associated with a 180% increase in the risk of all-cause mortality (HR: 2.80, 95% CI: 1.61–4.88) and a 233% increase in the risk of cardiovascular mortality (HR: 3.33, 95% CI: 1.43–7.75). Conclusions This study identified a U-shaped association between lnMETS-IR and mortality among CVD patients, underscoring the potential of METS-IR as a valuable prognostic marker for mortality risk in patients with CVD.

    Keywords: Metabolic score for insulin resistance, Mortality, Insulin Resistance, cardiovascular disease, NHANES

    Received: 13 Aug 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Su, Rao, Zhao, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xiaozhou Su, Department of Cardiology, Minzu Affiliated Hospital of Guangxi Medical University, Nanning, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.