Data are limited on the relationship between the cardio–ankle vascular index (CAVI) and non-insulin-based insulin resistance (IR) indices, including the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS-IR). In this study, we explored the relationship between TG/HDL-C, TyG, METS-IR, and the risk of increased arterial stiffness (CAVI ≥ 8.0) and compared their ability to detect arterial stiffness in the non-hypertensive Chinese population. A total of 3,265 non-hypertensive subjects were included. Spearman’s and partial correlation analyses were used to assess the relationship between non-insulin-based IR indices and CAVI. The correlation between these indices and the risk of a CAVI ≥ 8.0 was explored by multiple logistic regression analysis. The area under the receiver-operating characteristic curve was used to compare the ability of TG/HDL-C, TyG, and METS-IR to detect a CAVI ≥ 8.0. After adjustment for confounding factors, linear regression analysis showed that the CAVI changed by 0.092 [95% confidence interval (CI) 0.035–0.149] per standard deviation increase in TyG. While, this linear relationship was not found when analyzing TG/HDL-C and METS-IR. Multiple logistic regression analysis showed that the proportion of patients with CAVI ≥ 8.0 in the fourth quartile of TG/HDL-C [Q4 vs. Q1: odds ratio (OR) 2.434, 95% CI 1.489–3.975], TyG (Q4 vs. Q1: OR 2.346, 95% CI 1.413–3.896), and METS-IR (Q4 vs. Q1: OR 2.699, 95% CI 1.235–5.897) was significantly higher than that in the lowest quartile. The area under the curve that could discriminate CAVI ≥ 8.0 was 0.598 (95% CI 0.567–0.629) for TG/HDL-C, 0.636 (95% CI 0.606–0.667) for TyG, and 0.581 (95% CI 0.550–0.613) for METS-IR. In this study, we demonstrated a significant association between increased arterial stiffness and non-insulin-based IR indices. Among them, TyG showed better discriminatory ability than TG/HDL-C or METS-IR.

The authors aimed to characterize the relationships between non‐insulin‐based insulin resistance (IR) indexes and the risk of prehypertension, and to compare their abilities to identify prehypertension. The authors recruited 3274 adults who did not have hypertension and were not taking hypoglycemic or lipid‐lowering medications. The triglyceride‐to‐high‐density lipoprotein‐cholesterol ratio (TG/HDL‐C), fasting triglyceride and glucose index (TyG), and metabolic score for IR (METS‐IR) were calculated. Bivariate Spearman's correlation analysis and multiple logistic analysis were used. The area under the receiver operating characteristic (ROC) curve was used to compare the ability of the three indexes to identify prehypertension. Systolic and diastolic blood pressure (BP) positively correlated with TG/HDL‐C (r = .272, P < .001), TyG (r = .286, P < .001), and METS‐IR (r = .340, P < .001) in the entire cohort. Multiple logistic analysis showed that the proportion of prehypertension in the third and fourth quartiles of the TG/HDL‐C (Q3 vs. Q1: odds ratio (OR) = 1.527, 95% confidence interval (CI): 1.243–1.988; Q4 vs. Q1: OR = 1.580, 95% CI: 1.231–2.028), TyG (Q3 vs. Q1: OR = 1.519, 95% CI: 1.201–1.923; Q4 vs. Q1: OR = 1.658, 95% CI: 1.312–2.614), and METS‐IR (Q3 vs. Q1: OR = 1.542, 95% CI: 1.138–2.090; Q4 vs. Q1:OR = 2.216, 95% CI: 1.474–3.331) were significantly higher than in the lowest quartiles. The areas under the curves and 95% CIs for the identification of prehypertension were .647 (.628–.667) for TG/HDL‐C, .650 (.631–.669) for TyG, and .683 (.664–.702) for METS‐IR, respectively. Thus, non‐insulin‐based IR indexes (TG/HDL‐C, TyG, and METS‐IR) are significantly associated with the risk of prehypertension. Furthermore, METS‐IR is better able to identify prehypertension than TG/HDL‐C and TyG. These non‐insulin‐based IR indexes might assist with the prevention of hypertension in primary care and areas with limited medical resources.