Correlation Between Non-insulin-Based Insulin Resistance Indices and Increased Arterial Stiffness Measured by the Cardio–Ankle Vascular Index in Non-hypertensive Chinese Subjects: A Cross-Sectional Study

Abstract

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.

Association between triglyceride glucose index and arterial stiffness and coronary artery calcification: a systematic review and exposure-effect meta-analysis

“…1 ) [ 11 , 22 – 26 ]. Finally, ten cohort studies[ 14 , 27 – 35 ] and sixteen cross-sectional [ 9 , 15 , 36 – 49 ] studies were included in the present research, while the detailed reasons for the excluded articles are listed in Additional file 1 : Table S3.

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“…Table 1 presents the baseline characteristics of the included studies, which were published between 2017 and 2022, with a sample size ranging from 180 to 13,706 and a total of 87,307 participants. Among the included studies, 15 were from China[ 9 , 14 , 15 , 28 , 29 , 31 , 33 , 34 , 36 , 40 , 42 , 44 , 45 , 47 , 50 ], seven were conducted in Korea [ 27 , 30 , 34 , 35 , 37 – 39 ], three were from [ 42 , 48 , 49 ] Japan [ 41 , 47 , 49 ], and only one originated in non-Asia (United States) [ 43 ]. The mean age of participants ranged from 28.7 to 75 years, and the BMI ranged from 22.5 to 28.5 kg/m 2 .…”

“…Twelve studies [ 9 , 14 , 29 , 36 , 39 , 40 , 44 – 49 ] examined the TyG index as a categorical variable to evaluate the risk of arterial stiffness. The highest TyG group were associated with greater risk of arterial stiffness compared to the lowest TyG group (OR = 1.83, 95% CI 1.55–2.17, I 2 = 68%, τ 2 = 0.05) (Fig.…”

Screening and prediction of nonalcoholic fatty liver disease using a peripheral insulin resistance index: Potential benefits and limitations

“…METS-IR is associated with prehypertension, hypertension, arterial stiffness, and incident ischemic heart disease. [5][6][7][8][9][10] A recent study reported the dose-response association of METS-IR with new-onset NAFLD in a non-obese Chinese population. 11 The risk of incident NAFLD increased progressively with the METS-IR (Q1: reference; Q2: hazard ratio [HR] = 2.69, 95% confidence interval [CI] = 1.87-3.86; Q3: HR = 4.25, 95% CI = 2.86-6.30; Q4: HR = 6.40, 95% CI = 4.06-10.08, P < 0.001).…”

“…Even without circulating insulin levels in the equation, it can be validated using the euglycemic-hyperinsulinemic clamp data, frequently sampled in intravenous glucose tolerance test data, and a large cohort against the HOMA-IR. METS-IR is associated with prehypertension, hypertension, arterial stiffness, and incident ischemic heart disease [ 5 - 10 ]. A recent study reported the dose-response association of METS-IR with new-onset NAFLD in the non-obese Chinese population [ 11 ].…”