Journal of Clinical Lipidology · Oct 3, 2024
Associations of noninsulin-based insulin resistance indices with presence and extent of multiterritorial atherosclerosis: A cross-sectional study
By Zhang Y, Wang M, Cai X et al.
BACKGROUND: Noninsulin-based insulin resistance (IR) indices, simple and reliable surrogates for IR calculated without insulin level, have been reported to be associated with cardiovascular and cerebrovascular diseases. METHODS: Participants without diabetes from the cross-sectional baseline survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in the present study. Noninsulin-based IR indices, including triglyceride-glucose (TyG) index, triglyceride glucose-body mass index (TyG-BMI) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index, were calculated and stratified into quartiles. Intracranial, extracranial, coronary, subclavian, aorta, renal, ilio-femoral, and peripheral arteries were also assessed at baseline. RESULTS: Of 2759 included participants, the average age was 60.9 (± 6.6) years, and 1460 (52.9%) were female. Compared with the first quartile of TyG index, the fourth quartile of TyG index was associated with an increased presence and extent of atherosclerotic plaques (OR, 3.51; 95% CI, 1.30-1.87; common odds ratio [cOR], 2.22; 95% CI, 1.76-2.79) and presence and extent of atherosclerotic stenosis (OR, 1.60; 95% CI, 1.24-2.06; cOR, 1.66; 95% CI, 1.30-2.12). Such associations were also observed for the relationship of TyG-BMI index, TG/HDL-C ratio, and METS-IR index with the presence and extent of atherosclerotic plaques and stenosis. Addition of 4 noninsulin-based IR indices to the basic model with traditional risk factors improved the predictive performance of the presence of atherosclerotic plaque and stenosis. CONCLUSIONS: Elevated noninsulin-based IR indices levels were associated with an increased risk of presence and extent of atherosclerotic plaques and stenosis in non-diabetic, older individuals in the PRECISE study. Further, these IR surrogate markers have certain predictive performance to assess the risk of multiterritorial atherosclerosis.