Comparison of eight insulin-independent indices for identifying insulin resistance in Chinese young and middle-aged adults without diabetes: favorable performance of METS-IR and TyG-BMI

Résumé fourni par la source

Background Homeostasis model assessment of insulin resistance (HOMA-IR) mainly reflects basal IR, whereas dynamic measures such as the Matsuda index are less practical. Methods This cross-sectional study evaluated eight non-insulin-based metabolic indices [the metabolic score for insulin resistance [METS-IR], triglyceride-glucose body mass index [TyG-BMI], TyG, TyG-WC, LAP, TG/HDL-C, VAI, CMI] as IR surrogates in 710 Chinese adults without diabetes (aged 20–60 years). IR was separately defined using two criteria (1): HOMA-IR above the 75th percentile, and (2) Matsuda index below the 25th percentile, in normal-weight participants with normal glucose tolerance. Correlations, restricted cubic splines, and receiver operating characteristic (ROC) analyses were performed, including separate sex- and 10-year age-stratified subgroup analyses. Results METS-IR and TyG-BMI showed moderate correlations with both HOMA-IR and the Matsuda index. METS-IR, TyG, TyG-BMI, and TyG-WC were linearly associated with IR. In ROC analyses, overall AUCs for METS-IR and TyG-BMI were 0.776 and 0.770 for HOMA-IR-defined IR and 0.768 and 0.765 for Matsuda index-defined IR, indicating moderate discrimination. At cut-offs of 35.54 for METS-IR and 211.37 for TyG-BMI (which were consistent across both IR definitions), sensitivities were 66.1–68.9%, and specificities were 75.1–78.4%. Under the HOMA-IR definition, METS-IR had a significantly larger AUC than six indices, but not TyG-BMI. Under the Matsuda definition, its AUC did not differ from those of TyG-BMI, TyG-WC, LAP, or CMI. Rankings varied across subgroups. Conclusion METS-IR and TyG-BMI demonstrated comparable and favorable performance, serving as practical, insulin-independent initial screening markers for identifying elevated IR risk in Chinese young and middle-aged adults without diabetes. Rather than replacing insulin measurements, these indices offer valuable risk stratification tools in primary care or epidemiological settings where insulin assays are routinely unavailable.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.