Association of metabolic score for insulin resistance and its 6‐year change with incident type 2 diabetes mellitus

• Published in: Journal of diabetes Vol. 13; no. 9; pp. 725 - 734
• Main Authors: Zhang, Ming, Liu, Dechen, Qin, Pei, Liu, Yu, Sun, Xizhuo, Li, Honghui, Wu, Xiaoyan, Zhang, Yanyan, Han, Minghui, Qie, Ranran, Huang, Shengbing, Li, Yang, Wu, Yuying, Yang, Xingjin, Feng, Yifei, Zhao, Yang, Hu, Dongsheng, Hu, Fulan
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.09.2021; John Wiley & Sons, Inc
• Subjects: 2型糖尿病; Adult; Asian people; China; Diabetes; Diabetes Mellitus, Type 2 - metabolism; dose‐response; Epidemiology; Female; Glucose; Humans; Insulin Resistance; Male; metabolic score for insulin resistance; Metabolism; Middle Aged; Rural areas; Rural Population; type 2 diabetes mellitus; 剂量反应关系; 流行病学; 胰岛素抵抗代谢评分; China; epidemiology; 剂量反应关系; 胰岛素抵抗代谢评分; 流行病学; dose-response; type 2 diabetes mellitus; metabolic score for insulin resistance; 2型糖尿病
• ISSN: 1753-0393; 1753-0407; 1753-0407
• DOI: 10.1111/1753-0407.13161

Background The evidence for the association between metabolic score for insulin resistance (METS‐IR) and type 2 diabetes mellitus (T2DM) is limited. We aimed to explore the association of METS‐IR and its 6‐year change with risk of incident T2DM in a rural Chinese population. Methods We analyzed data for 12 107 participants (mean age 50.48 years). A Cox proportional‐hazard model was used to estimate the association of METS‐IR with incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs); a logistic regression model was used to assess the association of 6‐year METS‐IR change with incident T2DM by using odds ratios (ORs) and 95% CIs. We used subgroup analyses of the association of METS‐IR and its 6‐year change with incident T2DM by sex, age, and baseline fasting plasma glucose (FPG) level as well as restricted cubic splines to describe the dose‐response association. Results The association of METS‐IR and 6‐year METS‐IR change with incident T2DM was significant (per SD unit increase: HR = 1.80, 95% CI: 1.60‐2.02 for METS‐IR, OR = 1.42, 95% CI: 1.28‐1.57 and OR = 1.59, 95% CI: 1.44‐1.76 for relative and absolute METS‐IR change). The significant association remained on subgroup analyses by sex, age, and baseline FPG level. Dose‐response analysis demonstrated that the probability of incident T2DM was significantly increased with increasing METS‐IR and 6‐year METS‐IR change. Conclusions Increased METS‐IR and 6‐year METS‐IR change were positively associated with risk of incident T2DM in a rural Chinese population. METS‐IR may be a vital indicator for identifying T2DM. 摘要 背景 关于胰岛素抵抗代谢评分(Metabolic score for insulin resistance, METS‐IR)与2型糖尿病(Type 2 diabetes mellitus, T2DM)之间关系的证据有限。我们的目的是在中国农村人群中探讨METS‐IR及其6年变化与T2DM发病风险的关系。 方法 我们分析了12107名参与者的数据(平均年龄50.48岁)。Cox比例风险回归模型通过风险比(Hazard ratio, HR)和95%置信区间(Confidence interval, CI)估计METS‐IR与T2DM发病的关系；采用logistic回归模型通过比值比(Odds ratio, OR)和95% CI评估METS‐IR的6年变化与T2DM发病的关系。我们通过性别、年龄和基线空腹血糖(Fasting plasma glucose, FPG)水平对METS‐IR及其6年变化与T2DM发病的关系进行了亚组分析, 并使用限制性立方样条曲线探讨两者的剂量‐反应关系。 结果 METS‐IR及其6年变化与T2DM发生的关系显著(METS‐IR每增加一个标准差的单位:HR = 1.80, 95% CI: 1.60‐2.02；METS‐IR的6年相对和绝对变化量每增加一个标准差的单位:OR = 1.42, 95% CI: 1.28‐1.57和OR = 1.59, 95% CI: 1.44‐1.76)。METS‐IR及其6年变化与T2DM发生关系在按性别、年龄和基线FPG水平进行的亚组分析中仍存在显著关联。剂量‐反应分析结果显示, 随着METS‐IR及其6年改变量的增加, T2DM的发病风险显著增加。 结论 在中国农村人群中, METS‐IR及其6年变化量的增加与T2DM发生的风险呈正相关, METS‐IR可能是诊断T2DM的重要指标。 Highlights Increased METS‐IR and 6‐year METS‐IR change were positively associated with risk of incident T2DM in a rural Chinese population. We observed an association of METS‐IR and 6‐year METS‐IR change with incident T2DM by sex, age, and baseline FPG level. Dose‐response analysis revealed significantly increased probability of incident T2DM with increasing METS‐IR and 6‐year METS‐IR change.